The Flagship Program

The Flagship Course on Health System Strengthening and Sustainable Financing”

The Flagship Course on Health System Strengthening and Sustainable Financing has over two decades of continued experience as a global, regional and national capacity building program. In this time period, the course has reached over 20,000 participants and remains highly demanded by national governments and donor agencies.

This training course on health systems performance began in 1995, when several bilateral donors requested the World Bank to develop a capacity-building program for low- and middle-income countries to address an increasing interest in health sector and financing reforms. Over the next two years, the World Bank worked with a number of research institutions, including the Harvard School of Public Health, to build a program that was country-focused and was not ideological or prescriptive in nature. The resulting program has provided a global course held annually in Washington, DC; regional courses in all six major geographical regions served by the World Bank; and senior policy seminars and country-specific courses on selected themes, with a recent focus for many courses on Universal Health Coverage.

As global experience with health systems reforms accumulated, the Flagship Course has been updated and revised to reflect the growing knowledge base. This process has contributed to the continued demand for this learning program. Over time, the Flagship Course and its approach have been adopted and adapted by other health and development agencies, including USAID, WHO, the Global Fund to Fight AIDS, Tuberculosis and Malaria, GAVI, and the Bill & Melinda Gates Foundation.

For a review of experience with the Flagship Course, see this article in Health Systems & Reform.

Upcoming Courses

The Annual Global Flagship Course on Health Systems Strengthening and Sustainable Financing: The Challenge of Universal Health Coverage is scheduled for October 29 to November 6, 2018 in Washington, DC.

The Global Flagship Course is intended for teams of senior-level and mid-level policy makers working in health, health insurance, or finance, other government officials and development partners. The course will apply the Flagship’s analytic framework to engage participants in structured and strategic thinking about what it takes to move health systems towards universal health coverage.  The course methodology uses lectures, case-based learning, and peer interaction, and will explore significant issues in health financing, payment systems, organizational change, regulation, and influencing provider/client behavior.  Daily group work sessions give participants the opportunity to apply the course concepts and content to the specific situation in their own countries, and to interact with peers and the world-class faculty from Harvard University, World Health Organization, and World Bank.  Participants should end the course with a clearer sense of the options, constraints, opportunities and priorities in considering the next steps towards Universal Health Coverage in their own countries.

Just after the Global Flagship Course, the World Bank is offering two deep-dive courses to Flagship Course participants and others on specialized these topics.  The first one is “Quality in Primary Health Care” that will be delivered from November 7 to 9, and the second one is “The World Bank Health Projects Monitoring and Evaluation Course”, to be delivered from November 7 to 13, 2018.

Persons interested in the 2018 Global Flagship Course and follow-on courses should contact the World Bank’s course team leader Dr. Nedim Jaganjac at Strong preference is given to teams of 4-10 people from countries working with the World Bank on UHC-related health policies.

Regional and country Flagship Courses are also organized on a request basis, such as a regional Central American course and a national Laos course, both on December 10-14, 2018. Persons interested in organizing one of these courses should contact Dr. Nedim Jaganjac at

The Flagship Learning Workshop

On July 9 and 10, 2018, USAID’s Health Finance and Governance (HFG) project, in partnership with the World Bank, organized a Workshop on the Flagship Learning Program for the Next Decade in Washington, DC. The workshop was attended by 33 persons from 15 organizations prominent in health and development. The meeting marked an important milestone in twenty years of delivering the Flagship Course on Health System Strengthening and Sustainable Financing. The workshop provided a unique space for instructors, sponsors, and other thought leaders to reflect on how to update the Flagship Course for the next decade.

The workshop resulted in a productive set of discussions and proposals to revise and update the Flagship Learning Program moving forward. It also provided a valuable opportunity for sharing the history of the course’s development with the younger generation of course instructors.

Over two days, workshop participants engaged in discussions about what has worked and what has not worked, proposed revisions to the learning program, and explored what is needed to ensure the program’s sustainability. Focused discussions on specific sessions from the course resulted in the identification of areas for improvement in analytical methods, teaching objectives, and teaching methods including cases.

There was broad agreement among workshop attendees that the Flagship Program continues to be a valuable capacity-building and knowledge-transfer mechanism for health system actors. A key insight from the workshop was that the Flagship Learning Program has created a global Flagship community.

A summary of the workshop’s discussions and decisions can be found here. Follow-up discussions will be held to continue the momentum in updating the course.

Updating the Flagship Learning Program for the Next Decade

After the workshop, HFG supported seven experts to build on recommendations for revising content of the Flagship Learning Program. Professor Michael R. Reich led this initiative and provided oversight to authors who prepared materials that can be used to revise the Flagship Learning Program. The authors and products are listed in Table 1 below. The materials include synthesis reports on health system strengthening topics, updated and new course content to be used in future Flagship courses, and a glossary of terms used in the Flagship Program.

Due to time constraints for the HFG project, which ended on September 28, 2018, these materials are in various stages of completion: some are ready to be used in upcoming Flagship Courses, while others are considered drafts that require additional development prior to wider dissemination and use. As resources permit, stakeholders intend that future updated or new Flagship Learning Program materials will be completed and disseminated, possibly in a special issue of a peer-reviewed journal such as Health Systems & Reform.

To access any of the materials, email Professor Reich or the authors listed in the table below.

Table 1: Materials to revise the Flagship Learning Program

Topic Description Status* and Authors
Political analysis for health policy implementation Synthesis Report that presents new framework for political analysis of health policy implementation Draft, by Paola Abril Campos and Michael R. Reich


Regulation of the health sector Synthesis Report that summarizes current thinking and provides slides for use in a Flagship Course Draft, by Cheryl Cashin
Strategic health purchasing Synthesis Report that summarizes current thinking and provides slides for use in a Flagship Course Draft, by Cheryl Cashin
Glossary – Flagship Framework Glossary of terms that are used in the Flagship Framework Draft, by Anya L. Guyer
Guide for Flagship Course Directors Guide to assist individuals who are organizing and managing the delivery of a Flagship Course Draft, by Ravi Rannan-Eliya
NCDs and health systems Guide to module on NCDs and Health Systems and session briefs for five sessions Draft, by Ravi Rannan-Eliya
Access to medicines for NCDs Guide to module on Access to Medicines for NCDS, with slides and exercises for 3 sessions Final, by Veronika Wirtz
Social health insurance for Asia in the 21st century Slides and teaching notes for a session on social health insurance for Asia in 21st century Final, by Abdo Yazbeck

* Draft materials require peer review or additional work by the author(s), but still may be able to inform future Flagship courses in their current forms; final materials do not need any additional work in order to be used in future Flagship courses.