IHSP Goals and Approach
Many low and middle-income countries are committed
to improving the performance of their health care systems. They
face daunting challenges: the historical burden of infectious disease
and malnutrition, the increasing toll of non-infectious disease
and aging populations, rising expectations, and scarce resources.
To contribute knowledge and solutions to these problems, the International
Health Systems Program (IHSP) in the Department of Global Health
and Population at the Harvard T. H. Chan School of Public Health,
has gathered a highly experienced, multidisciplinary team of scholars
and experts to apply innovative approaches to improving health care
through research, training, and technical assistance. The IHSP is
committed both to advancing the state of relevant knowledge and
to bringing this knowledge to bear on appropriate applications to
achieve better health status, reduction in poverty, and gains in
human well-being for the poorer populations in both low and middle-income
To achieve these goals, IHSP works with many partners around the world.
We seek both to meet the specific needs of our collaborators, but also
to create learning that can contribute to solving the problems of others.
We also strive to enhance the skills and capacities of our partners for
further leadership. As a university-based group, IHSP is committed to
intellectual excellence and exchange based on mutual learning. As an active
participant in development projects, we are also dedicated to timely and
effective implementation of effective health system change.
Major Areas of Focus
IHSP’s research contributes to health system improvements worldwide by emphasizing six interrelated areas of focus. The combination of operations and academically-oriented research allow the findings and methodologies of Program members’ research to reach a wide audience and inform policymaking. A listing of peer-reviewed journal articles, project-related technical analyses and reports, and other material emanating from IHSP member research activities can be found on the Publications page.
The six areas of IHSP research include the most relevant issues for low- and middle-income countries. These areas include:
and capacity building. Many challenges faced by governments
around the world center around the management, organization and
effectiveness of their health systems. IHSP’s research
in this area emphasizes decentralization, organizational reform
of ministries of health, human resource strategic planning, and
case method management training.
Politics and governance. Technical solutions
to health systems deficiencies must take the political and governmental
contexts into account to be effective and sustainable. IHSP’s
research in this area emphasizes political strategies, advocacy
and approaches to working in fragile states.
Health system financing. Strengthening the
financial resources and reducing the financial risks of illness
that drive many into poverty requires innovative approaches in different
country contexts. IHSP’s research in this area emphasizes
social health insurance, community financing and national health
Public/Private partnerships. Involving and
working with the private sector is crucial to long-term improvements
in health systems quality and efficiency. IHSP’s research
in this area emphasizes assessments of private markets and public/private
Building community capacities. Community
involvement in delivery of health services is a key to promoting
healthy behaviors and utilization of the health system. IHSP’s
research in this area emphasizes the role of social capital in improving
health systems delivery.
Reproductive health and HIV/AIDS projects.
The Millennium Development Goals and worldwide efforts to control
the spread of HIV/AIDS have put a continuing concern on improving
reproductive health services. IHSP’s research in this
area emphasizes strengthening health system support for maternal
and neonatal health, shifting family planning preferences from abortion
to contraception and addressing economic and political aspects of
IHSP faculty and researchers have worked all over the globe in a
variety of country situations. Most recently we have been involved
in projects and training activities in India, China, Pakistan, Bangladesh,
Philippines, Nicaragua, Ukraine, Kosovo, Chile, Uganda, Turkey,
and Egypt. In the past, we have also had long term projects in Zambia,
Colombia and Poland.
National Health Accounts software
IHSP has been one of the leading innovators in the development of
a systematic approach to National Health Accounts including a NHA
software and contributions to the WHO, World Bank, USAID Producers
Guide to National Health Accounts
Policy Maker software for policy analysis and feasibility
forecasting. This software is a useful tool for assessing the political
map of support and opposition to health system reforms both large
and small and for developing political strategies to gain support
and reduce opposition.
Decision-Space mapping for decentralization assessment.
Based on an innovative approach to decentralization, this instrument
assesses the degree of choice over different key health system functions
that local officials are able to exercise. Survey instruments have
been developed in Nicaragua, Morocco, and Pakistan to assess the
actual, as opposed to the theoretical, "decision space" that local
Private Healthcare Market Mapping
This tool provides a comprehensive framework for assessing the extent
and major players of private market provision of services and provides
models for maximizing private sector contribution as well as enhancing
the Public-Private Partnership towards achieving social goals.
Innovative Training Programs
IHSP has been a major participant in the design and implementation
of the renowned Flagship Course on Health System Reform
and Sustainable Financing, which has been given annually
in Washington D.C. at the World Bank Institute and also in regional
and country programs.
IHSP was closely involved in organizing the China Senior
Health Leaders Training Program, a five-year program (2006-2010)
as part of the School's China Initiative.
IHSP also has a series of well-attended, two-week
executive training programs in Boston on policy and management
of decentralization, human resources strategic planning, quality
improvement, strategic planning, and public/private partnerships.
Through international collaborations, the IHSP is strengthening
the research and training capacity of institutions and gaining valuable
long-term partners for the continuing generation of high quality
knowledge on health reform issues. IHSP has had long-term collaborative
relationships with the University of Chile and the Catholic University
in Santiago Chile, the Institute of Public Health at the Jagiellonian
University in Krakow, Poland; National Health Accounts Networks
in Latin America, Africa, and the Middle East; the Central and Eastern
European Health Reform Network; and the China Network in Training
and Research in Health Economics and Financing. We also have strong
working relationships with Catalyst Management Services in Bangalore,
India; Contech in Lahore, Pakistan; Center for Economic Policy Research
(CEPR) in Manila, Philippines, ALVA, SA. in Managua, Nicaragua,
Fundacion Plenitude in Santo Domingo, Dominican Republic.
IHSP has received significant funding from a series of global and
bilateral USAID projects, including the Data for Decision Making
Project, Partnerships for Health Reform Project, Poland Health Reform
Project, Management and Leadership Project (Nicaragua), LEAD Project
(Philippines), Together for Health Project (Ukraine). The British
aid agency, DFID has provided global support for health reform research
and support for the Medium Term Strategy and Expenditure Framework
for Andhra Pradesh, India. The World Bank has collaborated with
IHSP on the Flagship Course on Health Reform and Sustainable Financing.
Sweden's SIDA has supported public private partnerships studies.
The Merck Foundation supported out of pocket payments studies in
five Central European countries.