Health System Assessment Approach: A How-To Manual

To help countries understand and strengthen their health systems, the Partners for Health Reformplus (PHRplus) (2001-2006) and Health Systems 20/20 (2006-2012) projects, with funding from the United States Agency for International Development (USAID), in collaboration with other projects and development partners, pilot tested and began developing the original Health System Assessment Approach in 2004. Since that time the approach has continued to be tested and the accompanying HSAA How To Manual adjusted as a “living document”.

The HSAA manual has been used to assess health systems and guide policymakers and program planners in many countries and regions. Health system assessment (HSA) results have contributed to national strategic plans, PEPFAR partnership frameworks, and numerous other Health System Strengthening (HSS) and programmatic activities. Based on lessons learned from experience and consultations with experts, Health Systems 20/20 has updated the Health System Assessment Approach: A How-To Manual and published Version 2.0 in 2012.

The approach covers key health system functions and is organized around WHO’s six health system building blocks: leadership and governance; health financing; service delivery; human resources for health; medical products, vaccines, and technologies; and health information systems. For more information, read the HSA brief.

HSAA Manual Version 2.0 – Full Text

Version 2.0 of the HSAA Manual by Section

Front Cover

Front Matter

Section 1. Introduction to the Health System Assessment Approach and Manual

These modules describe the technical grounding and methodological approach of the health system assessment. They also provide information on the content and use of this manual.

Section 1

Section 2. Conducting the Assessment
These five modules describe a five-step process of conducting a health system assessment.

Section 2

Section 3. Guidance on Assessing Health System Building Blocks
The modules in this section describe the indicators that can be used to assess each of the health system building blocks. The section also includes country stories and templates. The modules in Section 3 can be downloaded separately, depending on areas of interest.

Complete Indicator Summary

Section 3 Module 1: Country and Health System Overview

Section 3 Module 2: Leadership and Governance

Section 3 Module 3: Health Financing

Section 3 Module 4: Service Delivery

Section 3 Module 5: Human Resources for Health

Section 3 Module 6: Medical Products, Vaccines, and Technologies

Section 3 Module 7: Health Information Systems


Annex 1: Section 1 Supplemental Materials

Annex 2: Section 2 Supplemental Materials

Annex 3: Section 3 Supplemental Materials

Annex 4: Bibliography

Additional Guidance:

Engaging Stakeholders in Health System Assessments: A Guide for HSA Teams

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