HIGHLIGHTS
- In communities worldwide, many people can’t access health care, and quality is substandard, threatening survival and global stability.
- Abt helped 25 countries reform their own health financing, improve access to and quality of health services, and prevent and contain disease outbreaks.
- Increasingly self-reliant countries can better solve their own health system gaps and sustain citizens’ access to high-quality, affordable health services.
PROJECT
Local Health System Sustainability Project (LHSS)
The Challenge
Conflict, migration, and meteorological shifts are worsening health challenges and vulnerabilities around the world, including service delivery disruptions, changes in vectors and disease patterns, and rising rates of HIV, malaria, TB and other illnesses. Low- and middle-income countries often struggle to efficiently and effectively finance their health systems to counter these complex threats, endangering population health, regional stability, and global health security.
The Approach
Between 2019 and 2025, the Abt-led, USAID-funded Local Health System Sustainability Project (LHSS) collaborated with public, private, non-governmental, and faith-based organizations to develop new, more sustainable financing models and mechanisms for health systems and services. We introduced and advanced digital tools and approaches to streamline procurement and enable patients to easily access services. And we helped countries launch health security strategies to enhance their infectious disease surveillance systems, infection prevention and control, and biosafety and biosecurity.
Abt partnered with 720 local organizations to jointly design and implement tailored solutions, enabling continued progress and preparing countries for self-reliance. Globally, LHSS generated evidence, resources, and insights to help governments establish transparent national priority-setting processes for health; fully execute health budgets; engage with the private sector; and operationalize policies for higher-quality health care.
The Results
The US Government’s flagship initiative for integrated health systems strengthening helped 25 low- and middle-income countries transition to more efficient, accountable, and self-financed health systems.
Its longer-lens, systemic approach yielded lasting results even amid tumultuous times. The project started just before the pandemic and pivoted to establishing COVID-19 protocols in multiple countries to improve surveillance, clinical case management, laboratory testing, and communication strategies. Concurrently, as Colombia and Peru contended with millions of Venezuelan migrants, LHSS helped those countries enact new policies and models to deliver HIV and other services and medicines to migrants—and even enroll them in national health insurance plans, stemming onward migration. During active conflict in Ukraine, the project shepherded the rollout of telemedicine, ensuring Ukrainians could safely receive routine and even trauma-related health services.
Other standout results follow.
Diversified funding sources
Bangladesh: Supported intensive training of officials of six urban governments to fulfill new health accounting and budgeting responsibilities. All six governments reopened previously shuttered primary health care facilities, and five more than tripled budget allocations for health using internally generated revenue.
Colombia: Advised government implementation of innovative mechanisms such as Pay-for-Performance contracts. Notable partnerships with Novartis and Roche enhanced technical capabilities for early prevention and diagnosis of non-communicable diseases.
Democratic Republic of Congo: Analyzed how the government mobilizes, pools, and purchases health services and developed solutions in collaboration with the Ministry of Public Health’s Administrative and Financial Directorate to better monitor public expenditures, disburse more funding to the health sector, and unveil a new national financial protection approach.
Digital modernization & interoperability
Cambodia: Partnered with safety-net programs to create a digital infrastructure linking all multiple social protection databases and standing up a central, user-friendly registry, boosting patient use and transparency for policy makers, health service providers, and the banks that subsidize services.
Jordan: Advanced Ministry of Health efforts to deliver essential maternal and child health services via telehealth—especially to remote areas—including pre- and post-natal screenings, and consultations for women with high-risk pregnancies or for sick children.
Ukraine: Helped the Ministry of Health establish six public-private partnerships and a new law to broaden telemedicine use, including for AI-supported medical imaging analysis, virtual surgical consultations, telerehabilitation for people suffering from neurosensory disorders, remote pregnancy monitoring, and remote vital sign monitoring for patients with chronic diseases.
Infectious disease control and biosecurity
Jamaica: Convened government, civil society organizations, academia, and the private sector to develop a roadmap for the country’s first One Health initiative. The coalition brings together experts in human, animal, and environmental health to improve surveillance and early warning systems for vector-borne disease threats.
Kazakhstan: Collaborated with Ministries of Health, Agriculture, and Ecology to launch the country’s health security strategy, institutionalizing intergovernmental coordination and monitoring of zoonotic diseases, antibiotic resistance, and food safety to prevent regional and global outbreaks.
Tajikistan: Aligned the new global health security initiative with local religious leaders who promote values of cleanliness and stewardship, boosting community buy-in for clean water, waste management, and zoonotic disease prevention.
Header Photo: Valérie Baeriswyl for Communication for Development