Health Systems Strengthening

The World Health Organization defines a health system as all the organizations, institutions, resources and people whose primary purpose is to improve health. Strengthening health systems means addressing key constraints related to:

  • Service Delivery
  • Human Resources
  • Medicine and Technology
  • Financing Systems
  • Information Systems
  • Leadership and Governance

IMA World Health is a specialist in health systems strengthening, and we have more than a decade of improving delivery of health services in developing country settings, including post-conflict contexts. Wherever we work, our strategy is centered on our close partnerships with the Ministry of Health and local faith-based and community organizations.

Our History in the DRC

IMA World Health began working in the Democratic Republic of Congo (DRC) in 2000 to strengthen health zones destroyed by conflict and political instability. Our work includes primary health care, HIV/AIDS, malaria, neglected tropical diseases (NTD), and sexual and gender based violence (SGBV) prevention and treatment services.

Donor and Partner Feedback

“IMA has a remarkable ability to quickly learn and adapt its programs to be more effective.” Jo Yvon, Director for Health, UK aid Department for International Development

“ASSP is the only project that has delivered what they promised.” Minister of Health, West Kasai Province

Projet d’Accès aux Soins de Santé Primaire (ASSP)

Funding: $283M • UK aid and Swedish International Development Cooperation Agency • 2013 – 2018
Implementing partners: SANRU, World Vision, CARITAS, and the International Rescue Committee (IRC).

Technical partners: Tulane University, Pathfinder, HISP, and IntraHealth International.

IMA launched “ASSP” (or the Access to Primary Health Care Project)—our largest project to date—in 2013 to improve access to primary health care services for 9 million people in 56 health zones with the primary aim of improving the health of the mother, newborn and child. Supporting the Ministry of Health’s strategic objectives, IMA and our partners focus on improving the health system’s capacity to deliver malaria, pneumonia, diarrhea, nutrition interventions; obstetric and neonatal care; family planning; immunization; and water, sanitation, and hygiene interventions. Supporting activities include health center construction and rehabilitation, roll-out of the District Health Information System, and distribution of essential medicines and supplies.

Key Achievements This Year

  • Skilled births: 293,425 births attended by skilled health personnel.
  • Immunization: Immunized 294,416 children for measles.
  • IPTp: 201,730 pregnant women received two doses of intermittent preventive treatment for malaria prevention.
  • Malaria nets: 167,989 long-lasting insecticide-treated bed nets were distributed to both pregnant women and children under one.
  • Emergency obstetric care: 168 facilities are offering comprehensive emergency obstetric and neonatal care.
  • Fistula repair: A campaign to train local health workers in fistula repair and care resulted in 92 women being treated for urogenital fistulae.

Our History in South Sudan

Three years before South Sudan gained independence in 2011, IMA World Health began working alongside the Republic of South Sudan's government, international and national partners, and other health organizations to strengthen the health system in two of South Sudan’s most populous and geographically challenging states—Jonglei and Upper Nile. Driven by our health systems strengthening approach, IMA works with the county health departments to improve delivery of health services. In December 2013, a new conflict broke out in South Sudan, concentrated particularly in the regions we serve. In response, IMA is also supporting emergency primary health care and nutrition services in conflict-affected areas, allowing us to meet immediate needs while continuing to work toward long-term goals.

"Recent studies by the Liverpool Associates in Tropical Health (LATH) found that the two states where RRHP and its partners are working to improve health (Jonglei and Upper Nile) were ranked in the top three and had the most improved counties, nationwide."

(Source: South Sudan Health Facility Survey MOH/LATH)

Rapid Results Health Project (RRHP)

Funding: $33M • Ministry of Health with funding from the World Bank • 2013 - 2014
As a key partner to the national Ministry of Health, RRHP provides performance-based incentives to improve capacity of county health departments and health care facilities to deliver primary health care services to 3.3 million people living in Upper Nile and Jonglei States. Key focus areas include vaccination, care for pregnant mothers and children under five, and HIV/AIDS screening and prevention.

Key Achievements This Year

(January 2013 to June 2014):

  • Preventive services for children: 117,678 children received the third and final vaccination for diphtheria, pertussis, and tetanus (DPT3); 186,677 children received measles vaccinations; and 402,285 children received Vitamin A.
  • Curative services for children: 1,799,147 children under the age of 5 have received outpatient services.
  • Reproductive health: 134,874 pregnant women attended their first antenatal care (ANC) visit with 32,074 pregnant women (approx. 24%) attending all four of the recommended number of visits for ANC.
  • Essential medicines: Imported 733 cartons of essential medicine into South Sudan and distributed them to 24 counties to supply all 284 health care facilities.
  • Training: Trained 1,366 health care workers in Jonglei State and 14,941 in Upper Nile State in various topics such as maternal and child health, integrated management of childhood illness (IMCI), nutrition, and HIV/AIDS.

Reproductive Health Service Delivery

Funding: $418K • UNFPA • 2014
IMA is partnering with UNFPA and the State Ministries of Health in Lakes and Upper Nile States to support a mobile clinic to provide Reproductive Health (RH) services to local and IDP populations in Mingkaman, Awerial County, as well as re-establish Sexual and Reproductive Health (SRH) services in facilities in Akobo County that were destroyed or looted in the conflict that began in December 2013. IMA is improving the quality of existing SRH services and scale up services through support to the Bor State Hospital SRH outreach clinic.

Activities include:
  • Support outreach SRH activities in partnership with community-based organizations or support groups
  • Provide commodities
  • Provide technical oversight for training midwives

Emergency Medical Care and Nutrition Response for Internally Displaced Persons

Funding: $2M • USAID/Office of U.S. Foreign Disaster Assistance (OFDA) • 2014
Partners: Sudan Medical Care (SMC), Nile Hope Development Forum (NHDF), John Dau Foundation (JDF), and Coordination of Organizations for Voluntary Service (COSV)

In collaboration with the national Ministry of Health and partners, IMA provides emergency health care services by way of mobile clinics to an estimated 380,000 Internally Displaced Persons (IDPs) from Bor and Malakal Counties, among the counties most adversely affected by the 2013-2014 conflict, in Jonglei and Upper Nile states.

The project’s focus is to establish services for acute malnutrition and provide basic primary health care services (including antenatal, maternal and child health and reproductive health) including emergency health services via mobile clinics as well as rehabilitation of facilities and scale up of emergency services in key cluster areas of IDP settlements.

Key Achievements

(January 2013 to June 2014):

  • Health services: Treated an average of 14,000 patients per month at the 11 mobile and outreach clinic sites.
  • Mobile clinics: Rapid establishment and equipping of 9 mobile health clinics serving primarily 210,000 internally displaced persons due to fighting in Jonglei and Upper Nile States.
  • Net distribution:2,450 LLINS delivered to project sites.
  • Cholera: Cholera surveillance and prevention team sent to Upper Nile and Jonglei States to train on prevention, reporting and case management. One case detected in county served by mobile clinic.