About Health Systems
Partnering locally for integrated service delivery and systems strengthening.
PATH focuses on promoting models of integrated service delivery and systems, including supporting decision-makers to use data and evidence to strengthen local health systems and advance health equity.
We partner with countries to improve how data are captured, analyzed, visualized, shared, and used—which can mean the difference between information that is interesting and information that saves lives. To do this, PATH works along the data value chain, from strengthening the systems to collect data to cultivating the skills and culture to interpret and use data. We believe that acting on data and information is ultimately a human behavior, and accordingly, we build the skills, motivations, and opportunities to use data, especially at the primary health care (PHC) level.
We apply a mixed methods toolkit for unpacking complex challenges in the health system, generating actionable insight on what’s working, what’s not, and why. This approach ensures the triangulation of data and thorough validation of our findings.
- Supporting countries to accelerate impact
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From 2012 to 2021, PATH led multi-country, prospective evaluations of Gavi, the Vaccine Alliance and Global Fund investments in collaboration with the Institute for Health Metrics and Evaluation (IHME). Designed as embedded mixed methods evaluation platforms, the full country evaluations (FCEs) and prospective country evaluations (PCEs) provided timely country-specific evidence for programmatic course correction and synthesized cross-country evidence. These evaluations helped inform how Gavi and the Global Fund processes and policies are enacted in country to achieve objectives.
- Unpacking barriers and facilitators for scale-up
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PATH’s Asset Tracker monitors progress of scaling up evidence-based maternal, newborn, child health and nutrition (MNCHN) interventions—such as essential commodities, tools, approaches—including the barriers and enablers to achieving scale. The tracker identifies whether there are common and distinct pathways to scale for these interventions, with the aim of informing global, national, and local strategies for appropriately addressing barriers and opportunities for increasing coverage of MNCHN services. Our framework for data collection, analysis, and development of interactive dashboards allows us to create visualizations that show the pathways toward effective coverage.
- Reaching the unreached through innovation
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PATH leads the monitoring, evaluation, and learning component of the USAID-funded M-RITE: MOMENTUM Routine Immunization Transformation and Equity project, a global consortium led by JSI Research and Training, Inc. that seeks to reduce the number of unvaccinated, or zero-dose children, between 2020 and 2025. Across the project’s 18 countries, we co-design country-tailored approaches to reach zero-dose and under-immunized children and increase COVID-19 vaccination coverage. PATH leads implementation in the Democratic Republic of the Congo, Kenya, and Vietnam.
Using a human-centered design approach in Zimbabwe, Project “V” puts adolescent girls and young women (AGYW) in charge of managing their own health. Through co-creation with health providers and AGYW, the “V” intervention was designed to transform daily oral pre-exposure prophylaxis (PrEP) from a medicine to an easy-to-use, trendy self-care tool that resonated with AGYW. PATH developed the learning agenda and led a mixed methods evaluation of the feasibility, acceptability, and programmatic impact of the “V” intervention.
In Projecting Health, PATH supported a community heath intervention and evaluated it using a cluster-randomized controlled trial in 74 villages. During implementation, we partnered with a local civil society organization to create community-led and community-acted videos that conveyed key messages on child health and routine immunization and were screened in mothers’ groups for pregnant and lactating women. PATH evaluated the impact of this intervention on routine immunization, and found that although the intervention did not significantly impact routine immunization among the overall population, there was significant improvement in the probability of vaccination amongst children in ‘hard-to-reach’ communities.
Public health campaigns aim to deliver essential health services and products, augment or replace routine service delivery, target certain populations, or to accelerate progress towards coverage targets. PATH’s Root Cause Analysis and Rapid Evaluation, Action, and Learning toolkits recommend a systematic but flexible approach to identifying the root causes of challenges that impact public health campaigns. The toolkits provide “fit-for-purpose” rapid-testing and adaptive learning approaches to evaluation that integrates measurement and evidence-informed decision-making into daily practice.
- Catalyzing cross-country learning for smarter decision-making
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PATH’s COVID-19 Policy Tracker project rapidly collected, catalogued, visualized, and disseminated government policy responses and other information related to maintaining and adapting essential health services during the first year of the COVID-19 pandemic. Countries rapidly developed policies to limit disruption to essential health services, however, analysis of 198 policies from 53 countries revealed fragmentation and an overall proliferation of policies for maintaining essential services. To advance integrated, person-centered PHC, future policy development efforts should aim to integrate across essential health service areas.
Policies for strong PHC systems are essential to advancing health equity, but they are complex and difficult to design. We created the PHC policy tracker as a consolidated source of information to provide policymakers, advocates, and donors with data to shape policy dialogues—helping not only to identify strengths and weaknesses of PHC policies in your own country and around the world, but also to learn from others grappling with similar complex policy challenges.