Executive summary: This shallow investigation by Rethink Priorities, commissioned by Open Philanthropy, explores health systems strengthening (HSS) as a potential cause area and identifies several promising philanthropic opportunities—particularly Integrated Management of Childhood Illness (IMCI) mentorship and community scorecards—while emphasizing the field’s complexity, evidence gaps, and recent urgency due to USAID’s withdrawal from HSS funding in LMICs.
Key points:
Systemic health shortcomings are massive and underfunded: Poor quality and underuse of care in LMICs contribute to 5.7–8.4 million avoidable deaths annually, yet funding for HSS remains low and skewed toward service delivery, with limited investment in supply chains, governance, or data systems.
Philanthropic opportunities with high potential include:
IMCI mentorship and supervision (estimated ~8,500x cost-effectiveness), seen as a tractable and neglected intervention that improves the impact of existing child health programs.
Community scorecards (CSCs) (~3,100x), which promote accountability and improve service outcomes in low-cost, scalable ways.
Drug delivery and supply chain reforms (~3,300x), offering context-dependent but promising avenues to enhance medicine access and reduce stockouts.
Many HSS interventions are difficult to evaluate and may be undervalued: Complex system-level reforms (e.g. governance or financing) are under-researched due to attribution and measurement challenges, which may bias funders toward more easily quantifiable but potentially less transformative vertical interventions.
Case studies (e.g., Ethiopia, Thailand, Bangladesh) suggest that successful HSS involves coordinated efforts across financing, workforce, primary care, and governance, often paired with broader socioeconomic improvements.
USAID’s recent funding withdrawal has created urgent gaps in HSS capacity, particularly in technical assistance, data systems, and supply chains—experts highlight this as a key short-term philanthropic opportunity to stabilize critical systems and preserve institutional capacity.
Recommendations include further exploration of IMCI mentorship, CSCs, supply chain reforms, and innovative pilots, as well as longer-term support for governance and health information systems, with attention to neglected but high-leverage areas.
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Executive summary: This shallow investigation by Rethink Priorities, commissioned by Open Philanthropy, explores health systems strengthening (HSS) as a potential cause area and identifies several promising philanthropic opportunities—particularly Integrated Management of Childhood Illness (IMCI) mentorship and community scorecards—while emphasizing the field’s complexity, evidence gaps, and recent urgency due to USAID’s withdrawal from HSS funding in LMICs.
Key points:
Systemic health shortcomings are massive and underfunded: Poor quality and underuse of care in LMICs contribute to 5.7–8.4 million avoidable deaths annually, yet funding for HSS remains low and skewed toward service delivery, with limited investment in supply chains, governance, or data systems.
Philanthropic opportunities with high potential include:
IMCI mentorship and supervision (estimated ~8,500x cost-effectiveness), seen as a tractable and neglected intervention that improves the impact of existing child health programs.
Community scorecards (CSCs) (~3,100x), which promote accountability and improve service outcomes in low-cost, scalable ways.
Drug delivery and supply chain reforms (~3,300x), offering context-dependent but promising avenues to enhance medicine access and reduce stockouts.
Many HSS interventions are difficult to evaluate and may be undervalued: Complex system-level reforms (e.g. governance or financing) are under-researched due to attribution and measurement challenges, which may bias funders toward more easily quantifiable but potentially less transformative vertical interventions.
Case studies (e.g., Ethiopia, Thailand, Bangladesh) suggest that successful HSS involves coordinated efforts across financing, workforce, primary care, and governance, often paired with broader socioeconomic improvements.
USAID’s recent funding withdrawal has created urgent gaps in HSS capacity, particularly in technical assistance, data systems, and supply chains—experts highlight this as a key short-term philanthropic opportunity to stabilize critical systems and preserve institutional capacity.
Recommendations include further exploration of IMCI mentorship, CSCs, supply chain reforms, and innovative pilots, as well as longer-term support for governance and health information systems, with attention to neglected but high-leverage areas.
This comment was auto-generated by the EA Forum Team. Feel free to point out issues with this summary by replying to the comment, and contact us if you have feedback.