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Health system strengthening (HSS)

With the help of HSS support, countries can tackle weaknesses they have identified in their health systems which impede immunisation. GAVI believes strong health systems are central to increased immunisation coverage and to ensuring life-saving vaccines reach the world’s children.

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Breakdown of HSS proposed activities in countries. Source: WHO/UNICEF/UNFPA University of Queensland analysis of first 49 GAVI HSS proposals.

The GAVI Alliance Board has committed US $800 million over a five-year period to HSS. The funding is flexible and long term as barriers to immunisation vary from country to country and health ministries need to be able to plan improvements to best suit their needs. Frequently they include:

  • Limited local management and supervisory skills
  • Infrastructure failures (transport or equipment)
  • Workforce numbers, motivation and training

GAVI’s Health System Strengthening (HSS) support assists countries to overcome these bottlenecks which often impact other child and maternal health care initiatives too.

Barriers to immunisation (PDF 86K) outside the control of immunisation programmes, and which negatively affect the provision of services and reduce programme performance, is the subject of a report by Norad in 2004.

All GAVI-eligible countries can apply for HSS funding.

View HSS Principles.

Read how to apply for HSS.

Part of GAVI's strategy to strengthen capacity

One of GAVI’s four strategic goals is to contribute to strengthening the capacity of countries’ health systems to deliver immunisation and other health services in a sustainable manner.

As well as HSS support, GAVI provides two other types of support aimed at specifically at achieving this goal:

  • Immunisation services support (ISS)
  • Civil society organisation support (CSO)

Health Systems Funding Platform


The purpose of the initiative is to streamline health system strengthening support by the GAVI Alliance, the Global Fund to fight AIDS, TB and Malaria (GFATM), and the World Bank (WB). Streamlining support will reduce transaction costs for countries, increase efficiency, and therefore contribute to the achievement of internationally agreed Millennium Development Goals.

Unique opportunity

GAVI Alliance, GFATM, and the WB are the largest providers of support for health system development. Harmonising and eventually providing support through a joint system funding platform has the potential to significantly strengthen and improve health systems by:

  • lowering transaction costs for countries by harmonising proposal development and reporting;
  • increasing efficiency at country level through strengthened and more harmonised planning;
  • reducing fiduciary risk by employing joint funding mechanisms.

As recommended by the International Health Partnership and the High Level Task Force for innovative financing for health systems, GAVI, GFATM and the WB, with the support of the World Health Organization (WHO), are exploring opportunities for joint programming of the different organisations’ health system support.
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