GaneshAID Equity: Health System Transformation

GaneshAID Equity: Health System Transformation

Health system transformation is at the nexus of what we do. With practice areas that span service delivery, supply chains, data, information and technology, human resources, leadership, and governance, we leverage our core expertise to convert most pressing public health challenges into solutions. We apply the force of design thinking and creative problem-solving models to support countries toward data-driven innovations.

Optimizing People-centred Health and Immunization Systems

Good health and well-being underpin most of the Sustainable Development Goals (United Nations, 2017). GaneshAID focuses on two essential priorities:

  • changing health and immunization services to meet LMIC growing needs.
  • progressing towards universal health and immunization coverage, ensuring everyone gets the health services they need; and that nobody suffers undue financial hardship because of receiving care.

Unfortunately, not everyone can get access to affordable quality primary healthcare, especially for those are struggling to fulfil their basic healthcare needs…

| Maternal mortality is unacceptably high. About 295 000 women died during and following pregnancy and childbirth in 2017. The vast majority of these deaths (94%) occurred in low-resource settings, and most could have been prevented. The high number of maternal deaths in some areas of the world reflects inequalities in access to quality health services and highlights the gap between rich and poor. | – WHO

GaneshAID collaborates with Governments and partners to transform health and immunization people-centred systems for resilient service delivery, strong and flexible. We provide technical support to:

  • enhance the health workforce.
  • ensure equitable access to cost-effective medicines and technology.
  • boost health intelligence.

We provide high-quality technical assistance that focuses on national priorities and maximizes the effectiveness of a country’s resources.

Cultivating Innovations that Meet Communities’ Needs

Health and immunization systems in LMIC are facing the combined challenge of increasing needs because of a rising burden of chronic disease, vaccine preventable outbreaks, pandemics, and limited resources. This leads to an urgent need for reconsideration of the path which health services and systems are organized and supported. It is possible to improve services through innovation locally, but additional support is required to ensure they benefit all communities.

| Deliberate efforts should be made to strengthen the impact of (health) innovations that have been successfully tested in pilot or experimental projects with a view to reaching more people and encouraging formulation of policies and programs on a sustainable basis. |  – ExpandNet, WHO

Indeed, GaneshAID, together with partners worldwide, strives to transform the performance of health and immunization systems and the delivery of high-quality services to under-resourced and inadequately managed settings. Through our joint effort with global partners and national stakeholders, we provide innovation to reinforce health systems functions that are key to the improvement of health systems.

We provide high-quality technical and managerial assistance at all levels of the health system, with demonstrated excellence in implementing innovative programs across a wide range of public health areas.

Our innovations and new approaches aim to reinforce people-centred service delivery, health workforce performance, health intelligence, supply chain resilience, health financing, as well as leadership and governance.

| We cultivate innovation and scale-up high-impact practices to improve health and universal immunization coverage. | 

Change Framework for Successful Transformation

Innovation scaling up is a major challenge faced by many developing country governments, donors, and implementing agencies. Impact of new solutions/approaches are constrained unless they have larger policy and program impact. Likewise, demonstrated innovations cannot simply be handed over with the expectation that they will automatically become part of routine programme implementation. The scale up process needs intentional forces to increase the impact of successfully tested pilots to benefit more people and to adopt policy and programme development on a lasting basis.

New approaches to maintain routine immunizations during COVID-19 pandemic (Benin 2021)

GaneshAID supports Health systems innovations that are almost never straightforward. Our experience led us to empower countries managing changes for transformative long-lasting health and immunization service innovations. We support national leadership and ownership with tailor-made strategies including innovations adoption, implementation, sustaining, dissemination and scale up.

Our technical support involves an array of interventions and continuous adaptation to a changing health and immunization services and wider context, including political, cultural and institutional aspects.

Our technical support involves an array of interventions and continuous adaptation to a changing health and immunization services and wider context, including political, cultural and institutional aspects.

Our technical support involves an array of interventions and continuous adaptation to a changing health and immunization services and wider context, including political, cultural and institutional aspects.

Critical factors that positively influence the innovation full rollout method:

  • leadership and management that are supportive of and committed to change, including the articulation of a clear and compelling vision.
  • dedicated and ongoing resources, including funding, staff, infrastructure, and time.
  • early and widespread stakeholder involvement, including staff and service users.
  • effective communication across the organization.
  • ongoing adaptation of the innovation to the local context.
  • ongoing monitoring and timely feedback about progress.
  • evaluation and demonstration of the (cost-)effectiveness of the innovation being introduced, including assessment of health benefits.

Innovation Scales up and Change Management Projects

The scale-up process is envisioned as a mechanism to increase the number of users/beneficiaries in local conditions and study the innovations’ results and impacts in terms of increased performance of health workers (knowledge and skills), and consequently improved people-centred service delivery. GaneshAID technical support focuses on organizational development that addresses necessary health service transformation – modernizing workforce performance development model.

We support Ministries of Health formulating appropriate strategies to introduce planned change necessary to scale up the successfully tested innovation. This is critical to assist governments coping with the turbulent environment and the absolute necessity to save more lives and protect communities from diseases and outbreaks.

Scaling up an EPI performance coaching model in Senegal – Coach2PEV

GaneshAID suggests applying a scaling up process to facilitate the strategic planning and management of the expansion of Coach2PEV. Organizing this process requires decisions from national stakeholders, in-country implementing partners and donors, about the overall scale up implementation with a combination of organizational approaches:

  • centralized (top-down) or decentralized (bottom-up),
  • adaptive depending on the context,
  • phased-gradual-rapid implementation,
  • participatory or expert-oriented approach.

In a perspective of constant collaboration, GaneshAID adopts a participatory approach to involve the main stakeholders in the development and testing of new interventions. Indeed, Coach2PEV was designed to be simple and integrated into the existing health and immunization system, with the aim of modernizing the classic approach of supervision by coaching the performance of staff of the national immunization program in Senegal.

To do this, a strategy is proposed for planning the scaling up of Coach2PEV in Senegal.

Depending on the decision of national actors, the scaling strategy includes three phases to intensify the new intervention according to the context of Senegal / Benin.

Key Phases of the Innovations Scaling Up strategy

Scaling up an EPI performance coaching model in Senegal – Coach2PEV

GaneshAID suggests applying a scaling up process to facilitate the strategic planning and management of the expansion of Coach2PEV. Organizing this process requires decisions from national stakeholders, in-country implementing partners and donors, about the overall scale up implementation with a combination of organizational approaches:

  • centralized (top-down) or decentralized (bottom-up),
  • adaptive depending on the context,
  • phased-gradual-rapid implementation,
  • participatory or expert-oriented approach.

In a perspective of constant collaboration, GaneshAID adopts a participatory approach to involve the main stakeholders in the development and testing of new interventions. Indeed, Coach2PEV was designed to be simple and integrated into the existing health and immunization system, with the aim of modernizing the classic approach of supervision by coaching the performance of staff of the national immunization program in Senegal.

To do this, a strategy is proposed for planning the scaling up of Coach2PEV in Senegal.

Depending on the decision of national actors, the scaling strategy includes three phases to intensify the new intervention according to the context of Senegal / Benin:

Key Phases of the Innovations Scaling Up strategy

Scaling up rapid and social learning during COVID-19 pandemic in Benin – VacciForm

EPI Benin confirmed willingness to scale up VacciForm, considering the rapid m-learning solution as an appropriate strategy to cope with the Covid-19 pandemic. The digital solution was approved by the Minister of Health and the National Agency for Information Systems, supported by the Information System Directorate (DSI). EPI focuses on digitization and adoption of new methods to improve immunization performance. Vacciform will be incorporated as part of the upcoming e-learning strategy under development by the DSI.

The pilot test of Vacciform was conducted over 2 weeks but the 26 users were only effective for one week, the 1st week concurring with the child survival week in Benin. The results of this pilot test served to improve the functionality of the digital solution before the scale-up phase.

GaneshAID strives to optimize the VacciForm solution for offline internet mode. We pursue collaboration with EPI and DSI to develop the scale-up strategy including advocacy, institutionalization, promotion of the solution, and synergies with the Ministry of health eLearning strategy and the scale-up phases of the solution, with a first plan of targeting 10-20% vaccinators within 18 months.

The main activities of scaling up are organized by activity package:

  1. National leadership and ownership with an endorsed VacciForm scale-up strategy.
  2. Dissemination and advocacy.
  3. Organizational process.
  4. Resource mobilization for ongoing adaptation of the innovation to evolving immunization service’s needs.
  5. Monitoring, evaluation, and learning.

The main purpose is to maximize the utilization of VacciForm by vaccinators in Benin, ensuring skilled vaccinators provide communities with safe immunization activities during the Covid-19 pandemic.

Reorganized fixed immunization session in Benin, 2021 (Credit Landry Kaucley – EPI Manager)