Advice from the pros: 3 tips for succeeding as a health systems strengthening expert

Health systems strengthening experts are key contributors to global development. They work across disciplines to identify and implement change and improvement in a country’s health system. Devex spoke with Zana Somda, an independent consultant with 12 years’ experience in health systems strengthening and over 25 years’ experience in global development. He has worked extensively with the Palladium Group, U.S. Centers for Disease Control and Prevention, and Population Services International. Somda shared insights and key tips with Devex on how to succeed as a health systems strengthening expert. 1. Integrate into the local context “What has been helpful for me is collaborative work with the national and local population,” Somda explained, “to really have an idea of the health situation in a local context.” Through collaboration, you can respond more effectively and efficiently to the local population’s needs. Somda advised health system strengthening experts to integrate into the field as much as possible. Somda emphasized the importance of “knowing your local context — particularly at the community level. Because that is where the needs are expressed the most.” Health system strengthening projects are commonly three to five years long and Somda advises staying at the country level for the whole period to provide continued on-the-ground technical assistance. “Collaboration, participative, and evaluative work is one approach I use in my work,” he said. And this collaborative approach needs to exist at all levels, “from the community, through the district, and up to the national level.” By having the community at the “centerpiece of the approach,” you will be able to better understand — and therefore improve — the local community’s health, he continued. The national health system could also be improved in this way. By being in the field, or having some “key link with some field activities,” you can really follow up with “what is important” at that level. But in order to integrate into the local community, you need to develop “relationships with community leaders, stakeholders at the community level, or [a] ‘gatekeeper.’” Someone who can introduce you and assist in building relationships. 2. Experience in other sectors can help Experience in other fields of development can be extremely useful in understanding external factors and the context surrounding health systems, which can influence both your approach and work. Somda didn’t begin his development career in the health sector. Prior to that, he had 15 years of experience in the agricultural sector, and he advocates that this experience was very useful and transferable to health systems strengthening. It gave him prior knowledge in nutrition, crop production, and food security, which have an impact on a country’s health sector, and vice versa. “It helped me to integrate the two domains, the two fields,” he said. Don’t be afraid to transition into health if you have experience in a different sector, Somda advises. This knowledge could very well translate, and be a useful resource for health systems work. 3. For monitoring and evaluation, one size doesn’t fit all When it comes to data collection, analysis, and monitoring and evaluation, you can’t use the same tools or technologies for every project, Somda explained. While one project may require a “survey instrument or a key informant interview” to understand the local context, another may need a different strategy to obtain results — or all of those combined in a mixed-method approach. “You have to develop a data collection tool tailored or specific to the program you are working on — [depending on] what kind of data you need,” he explained. “Your tool has to be able to capture the information and the data, and then use … [a] data analysis tool to ... make sure that you are achieving the goal or particular impact of the program,” he continued. Knowledge of monitoring and evaluation technique and framework can be a very useful methodology for health systems strengthening experts, said Somda, adding that HIV and reproductive health is “a key area making use of monitoring and evaluation system.” Using this system, you decide which methods of data collection and analysis are most appropriate. Laying out “the logframe (logical framework), the data collection tool, the performance monitoring improvement system tool,” and so on, to provide a clear structure, aims, and way to measure the outcomes and success of a project. “In monitoring and evaluation, you use various quantitative and qualitative data management tools,” he explained. “I don’t think you can recommend one specific tool across the board. Like they say, it is not one size fits all. You have to be specific to your need and the program.” Want to work in health systems strengthening? See all related jobs posted on Devex here.