Strengthening Public Sector Health Systems & Health Workforce
We advocate for equipping public sector health systems with the people, facilities, equipment, and systems they need to provide high quality, primary health care.
Health systems include “building blocks” such as a health workforce, health facilities where services are delivered, drugs and technologies needed to provide care, information management systems, and the financing, leadership and governance structures needed to fund and manage the whole system. Underlying all of this are the people who use the health system, whose needs should drive the system to continually improve and evolve.
Governments with underresourced and, as a result, poorly functioning health systems are not only ill-equipped to respond to health emergencies (such as an Ebola outbreak or the COVID-19 pandemic), they often struggle to provide basic primary health care on a daily basis.
In response, big donors and wealthy governments often channel money to the private and social sectors, including to international NGOs (like HAI). In the quest to see progress, international donors often fund disease-specific and time-limited services. These programs may deliver results in the short-term, but when they circumvent the public sector, they can lead to fragmented and inefficient health care and leave the primary health care system used by the poorest and most vulnerable populations wanting for critical resources.
At HAI, we believe that governments are best positioned to provide high-quality, comprehensive health care to all citizens. That’s why we advocate for NGO programs that operate in close collaboration with ministries of health and support their efforts to improve care for all.
SPOTLIGHT: Pillar I
The NGO Code of Conduct
The NGO Code of Conduct was created for service organizations, funders and host governments as an accountability tool to encourage NGO practices that contribute to building public health systems and discourage those that are harmful.
The Code was drafted in 2007 by a coalition of activist and service delivery organizations, led by Health Alliance International.
Health systems are a country’s mechanism for taking care of its people. If you want to help: strengthen the National Health Service.
Sign ons & Resolutions
- Supporting and Sustaining the Home Care Workforce to Meet the Growing Need for Long-Term Care, APHA Resolution policy statement, October 24, 2020 [Resolution]
- Statement Concerning the United States Government’s Decision to Terminate Relations with the World Health Organization (WHO), statement to the United States Government, June 2020 [Sign-on]
- Call to Urgently Prioritise International Funding Support for the Recruitment of Human Resources for Health in Resource-Limited Contexts Amid COVID-19, letter to GAVI, WHO, IMF, The World Bank, GFF, and GFATM, April 22, 2020 [Sign-on]
- Public Health and Early Childhood Education: Support for Universal Preschool in the United States, APHA Resolution policy statement, November 7, 2017 [Resolution]
- Reducing Income Inequality to Advance Health, APHA Resolution policy statement, November 7, 2017 [Resolution]
- Strengthening the Health Workforce Language in the United Nations Sustainable Development Goals, letter the United Nations Secretary-General, January 16, 2015 [Sign-on]
- Strengthening and Updating Social Security to Protect Our Nation’s Health, APHA Resolution policy statement, November 5, 2013 [Resolution]
- Urge members of the House Committee on Foreign Affairs to support the Global HEALTH Act, letter to the United States Committee on Foreign Affairs, March 24, 2010 [Sign-on]
- Please Co-Sponsor HR 2293, The Public Health Trade Advisory Committee Act, Letter to the United States Congress, July 7, 2009 [Sign-on]
- Stop Aids Letter to the Obama Transition, civil society letter to the Obama Administration, November 14, 2008 [Sign-on]
- Physicians for Human Rights World Aids Day Letter, letter to the Obama Administration, December 1, 2008 [Sign-on]
- Letter to the World Bank Regarding Revised Health Nutrition and Population Strategy, letter to the Executive Director of the World Bank, April 17, 2007 [Sign-on]
- A Call to the 2007 G8 Summit to Support African National Health Plans and Comprehensive Health Workforce Strategies, ACOSHED and AMREF letter to the G8, May 21, 2007 [Sign-on]
- NGO Code of Conduct for Health Systems Strengthening, endorsement of Code, 2007 [Sign-on]
Statements & Publications
- NGOs, austerity, and universal health coverage in Mozambique, Global Health, 2019 [Publication]
- Austerity in Africa: Audit cultures and the weakening of public sector health systems, Focaal, 2019 [Publication]
- Donor data vacuuming: Audit culture and the use of data in global health partnerships, Med Anthropol Theory, 2018 [Publication]
- Critical perspectives on global health partnerships in Africa, Med Anthropol Theory, 2018 [Publication]
- The Health Impacts of “Zero-Tolerance”, statement to the United States Government, July 13, 2018, [Statement]
- An Anthropology of Aid in Africa, Lancet, 2015 [Publication]
- The end of AIDS and the NGO Code of Conduct, Lancet, 2014 [Publication]
- The Struggle for a Public Sector: PEPFAR in Mozambique, When People Come First, 2013 [Publication]
- Vertical Funding, Non-Governmental Organizations, and Health System Strengthening: Public Sector Health Workers in Mozambique, Hum Resour Health, 2013 [Publication]
- Integration of HIV/AIDS services into African primary health care: lessons learned for health system strengthening in Mozambique—a case study, J Int AIDS Soc, 2010 [Publication]
- Do International Medical Graduates (IMGs) “Fill the Gap” in Rural Primary Care in the United States? A National Study, J Rural Health, 2009 [Publication]
- Job Satisfaction And Morale In The Ugandan Health Workforce, Health Aff, 2009 [Publication]
- The role of nonphysician clinicians in the rapid expansion of HIV care in Mozambique, J Acquir Immune Defic Syndr, 2009 [Publication]
- Strengthening health systems in poor countries: a code of conduct for nongovernmental organizations, Am J Public Health, 2008 [Publication]
- International NGOs in the Mozambique health sector: the” velvet glove” of privatization, Unhealthy Health Policy, 2004 [Publication]
- International NGOs and primary health care in Mozambique: the need for a new model of collaboration, Soc Sci Med, 2003 [Publication]
Op-Eds, News & Events
- Needed Medications Arrive in Mozambique, Direct Relief, 2019 [News]
- Cyclone Idai Destroyed Their Hospital. These Two Doctors Never Stopped Treating Patients., Direct Relief, 2019 [News]
- 1 doctor, 2 million patients: Mental health care in Africa, KUOW, 2019 [News]
- ALMA-ATA at 40: Civil Society Continues the Commitment to Health for All, Health and Human Rights Journal, 2018 [Op-Ed]
- Enabling Learning Systems: the African Health Initiative in Mozambique, video premier, 2018 [News]
- Get ready for your close up: HAI’s IDEAs project on film, sneak peek of film on IDEAs Project, 2018 [News]
- What caused the West African Ebola outbreak? Healio: Infectious Disease Network, 2017 [Op-Ed]
- Day of Action: Our Health Is Not For Sale, People’s Health Movement (PHM) and Health Alliance International (HAI) event for the International Day of Action against privatization of health, April 7, 2017 [Event]
- Preventing Infant Deaths: What can we learn from Cuba? Huffpost, 2015 [Op-Ed]
- Health and Justice in a Time of Austerity, AJPH, 2015 [Op-Ed]
- Health Alliance International, commits a total of US $21,780,000 over the next 3 years towards the attainment of MDGs 4 and 5, WHO Sustainable Goals Partnerships Platform, 2015 [News]
- Volunteer Recap: Connecting Moms To Midwives In Timor-Leste, KUOW, 2015 [News]
- Is global health about gizmos or people? Humanosphere, 2014 [Op-Ed]
- Officially, over 2 million children under-5 don’t exist in Mozambique, Healthy Newborn Network, 2014 [Op-Ed]
- Opportunities Lost — Could Ebola Have Been Better Contained? Huffpost, 2014 [Op-Ed]
- Seattle parties to help ‘Mobile Moms’ in Timor-Leste, Humanosphere, 2012 [News]
- ‘Mobile Moms’ to boost health of women in Timor-Leste, UW SPH News, 2012 [News]
- Stemming the brain drain of health-care workers from developing countries, The Seattle Times, 2010 [Op-Ed]
- Gently combating harmful childbirth traditions, The New Humanitarian, 2009 [News]
- Support Efforts to Boost Health Care for Africans, The Seattle Times, 2007 [Op-Ed]
- G-8 Commitments to Africa Unfulfilled, Seattle PI, 2007 [Op-Ed]
who we fight alongside
Explore the rest of HAI’s Advocacy Pillars
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Stand with HAI
Stand with HAI
Our mission is to promote policies and support programs that strengthen government primary health care and foster social, economic, and health equity for all. Our vision is a just world that promotes health and well-being, including universal access to quality health care.
Health Alliance International began in 1987 as a US-based international solidarity organization committed to supporting the public sector provision of health care for all. Over 35 years, HAI conducted programs in 17 countries, with flagship programs in Mozambique, Côte d'Ivoire, and Timor-Leste.
In line with HAI’s commitment to support and strengthen local public health leadership, as of October 2021, HAI fully transitioned global operations and active programs to locally-based, locally-led NGOs. Learn more about this shift toward local autonomy and equity in global health.