Health Systems Strengthening

PEPFAR has had a positive impact on the capacity of country health systems to address the WHO's six building blocks of health systems functions. However, the program to date has not placed a deliberate focus on the strategic strengthening of health systems. In its next phase, PEPFAR is working to enhance the ability of governments to manage their epidemics, respond to broader health needs impacting affected communities, and address new and emerging health concerns. PEPFAR now emphasizes the incorporation of health systems strengthening goals into its prevention, care and treatment portfolios. Doing so will help to reduce the burden of HIV/AIDS on the overall health system. Planned activities include the following:

  • Training and retention of health care workers, managers, administrators, health economists, and other civil service employees critical to all functions of a health system;
  • Implementing a new health systems framework to assist country teams in targeting and leveraging PEPFAR activities in support of a stronger country health system;
  • Supporting efforts to identify and implement harmonized health systems measurement tools; and
  • Coordinating USG activities across multilateral partners to leverage and enhance broader health system strengthening activities.

Targets from Fiscal Year (FY) 2010- FY 2014:

  • Support training and retention of more than 140,000 new health care workers to strengthen health systems.

Progress Achieved through September 30, 2009:

  • Tables with results achieved by PEPFAR health systems strengthening programs during Fiscal Year (FY) 2009 may be found here.

For more information on PEPFAR's data collection, please visit:

Programmatic Strategy: In this second phase of PEPFAR, a new program strategy is underway that supports the Administration's overall emphasis on improving health outcomes, increasing program sustainability and integration, and strengthening health systems. Some of these changes are already being implemented with planning and programming for FY 2010. Over the next year, PEPFAR will be working closely with country teams in order to translate, prioritize, and implement this strategy in a manner appropriate to the country context. More information on the broader strategic framework for PEPFAR activities can be found in the strategy annexes which will be made available at