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AJPH First Look, published online ahead of print Jan 31, 2006
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March 2006, Vol 96, No. 3 | American Journal of Public Health 435-440
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2004.059907

OPPORTUNITIES AND DEMANDS IN PUBLIC HEALTH SYSTEMS

Helping Public Sector Health Systems Innovate: The Strategic Approach to Strengthening Reproductive Health Policies and Programs

Peter Fajans, MD, MPH, Ruth Simmons, PhD and Laura Ghiron, MPH

Peter Fajans is with the Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland. Ruth Simmons and Laura Ghiron are with the Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Mich.

Correspondence: Requests for reprints should be sent to Peter Fajans, MD, MPH, Dept of Reproductive Health and Research, WHO, 1211 Geneva 27, Switzerland (e-mail: fajansp{at}who.int).

Public sector health systems that provide services to poor and marginalized populations in developing countries face great challenges. Change associated with health sector reform and structural adjustment often leaves these already-strained institutions with fewer resources and insufficient capacity to relieve health burdens.

The Strategic Approach to Strengthening Reproductive Health Policies and Programs is a methodological innovation developed by the World Health Organization and its partners to help countries identify and prioritize their reproductive health service needs, test appropriate interventions, and scale up successful innovations to a subnational or national level. The participatory, interdisciplinary, and country-owned process can set in motion much-needed change.

We describe key features of this approach, provide illustrations from country experiences, and use insights from the diffusion of innovation literature to explain the approach’s dissemination and sustainability.






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