Health Systems Strengthening Report

USAID cross-cutting health system strengthening (HSS) activities are defined by USAID in the Foreign Assistance Standardized Program Structure and Definitions (SPSD) as “overarching activities that are supported with multiple health element funding.” Activities that meet this definition are those funded through two or more program area funding streams within a single implementing mechanism/project and are expected to impact and support multiple health program areas.

Cross-cutting health system strengthening (HSS) activities are defined in the Foreign Assistance Standardized Program Structure and Definitions (SPSD) as “overarching activities that are supported with multiple health element funding.” These activities are expected to impact and support multiple health program areas and are called for where a comprehensive approach would result in system-wide efficiencies and/or improved integrated health system performance as compared to program area-specific interventions.

Beginning with the FY19 planning cycle, USAID’s Bureau for Global Health (USAID/GH) amended program planning guidance to encourage Missions to invest in health systems strengthening (HSS) activities funded by multiple health elements. The guidance specified that Missions must devote resources toward such co-funded cross-cutting health systems, consistent with existing legal authorities on the use of funds. The intent of this change in guidance was to encourage Missions to invest in cross-cutting aspects of HSS. The guidance includes technical considerations for how to design HSS programs, according to state-of-the-art practice.