A new Health Systems Assessment tool

Strengthening a health system begins with understanding its components and dynamics inside out. Aid interventions aiming at strengthening a health system should be informed by its capacities and performance. In fragile and conflict affected settings assessing a health system to inform programming is a complex task challenged, beyond the very much discussed access limitations, by multi-layered realities, grey zones in stakeholders' roles and interactions, contextual socio-political fluidity, structural chaos, weakened formal governance arrangements and numerous other organically developing factors. UHC2030 technical working group on fragile and conflict-affected settings realized in 2018 that humanitarian aid as well as development cooperation organisations are often ill-equipped to perform accurate health systems assessments in complex environments. Existing health system assessment tools have not been conceived for application in contexts affected by prolonged crises and other emergencies. Therefore, commissioning the creation of a working tool aimed at guiding the analytical process of aid professionals according to fragility-sensitive parameters is a first step towards creating some common understanding of fragility patterns and informing relevant interventions, while recognizing through capillary examination of a wide range of such settings the incredible heterogeneity of fragile settings.

On June 2^nd the tool was officially published and can be found on the following link: https://www.uhc2030.org/fileadmin/uploads/uhc2030/Documents/About_UHC2030/UHC2030_Working_Groups/2017_Fragility_working_groups_docs/UHC2030_Guidance_on_assessing_a_healthcare_arena_under_stress_final_June_2019.pdf

It is considered a work in progress and comments, particularly from users, are still very welcome by the authors, as well as the UHC 2030 group, although the formal consultative process is long closed. This newsletter's readers are encouraged to test the tool in their area of work and provide feedback as appropriate.