Health System Assessment Approach: A How-To Manual Version 3.0

Dear Colleagues,

USAID’s Office of Health Systems and the Health Finance and Governance Project (HFG), in collaboration with WHO, have undertaken the revision of the Health Systems Assessment Approach (HSAA).  This collaborative effort has included technical leadership from USAID’s central health systems projects, including  Applying Science to Strengthen and Improve Systems (ASSIST), Systems for Improved Access to Pharmaceuticals and Services (SIAPS), Promoting the Quality of Medicines (PQM), Human Resources for Health 2030 (HRH 2030), and MEASURE Evaluation.

Our update of the manual focused on three broad tasks:

  1. Technical updates from subject experts from the above listed projects and WHO;
  2. Assessing the health system’s ability to effectively undertake core functions to achieve universal health coverage; and
  3. Adding more ‘systems thinking’ guidance and techniques

We are requesting your feedback on this latest version, and through HFG, have posted draft Version 3.0 below for your review and comment.

Our collective goal is to broaden the audience and the use of the HSAA manual. We welcome all comments.  However, we would specifically be interested in hearing your thoughts on the following:

  1. From your point of view (in your mission, bureau, or office), what is the best way to utilize this tool in a way that is country-owned, and complementary to other tools and approaches in the field?
  2. How can this tool best be utilized to support missions, ministries and other country partners in health systems strategy and planning?
  3. In launching the HSAA, what individuals and/or groups would find this tool most useful?

Please note that, for ease of review, the manual is posted as nine separate files. Please feel free to select some or all file(s) to peruse.

Please also note that this version is still a draft, and has not yet been professional copy-edited and formatted.  We welcome your feedback and comments via e-mail to by Thursday, December 8th.

Thank you in advance for your feedback as it will help us make this manual a better product.

Best regards,

Jodi Charles
Catherine Connor
Minki Chatterji

Front Cover

Front Cover

Front Matter

Front Matter

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

Section 1

Section 2. Steps of the HSAA: Conducting the Assessment

Section 2

Section 3. Guidance on Assessment of the Health System and Its Core Functions

Module 1: Country and Health System Overview

Module 2: Service Delivery

Module 3: Human Resources for Health

Module 4: Medical Products, Vaccines, and Technologies

Module 5: Health Information System

Module 6: Health Financing

Module 7: Governance