Health systems strengthening


Johns Hopkins University






David Bishai, Johns Hopkins University

Quality Improvement in Public Health Practice for Angola’s District Health Officials


The issue
In any health system, most resources are devoted to delivering health services and commodities to take care of sick individuals, and only 1 to 5 percent is devoted to population level public health functions that keep healthy populations healthy. An effective response to HIV/AIDS requires high quality and high capacity in both caring for patients and public health functions to prevent disease. Most health systems have personnel who are nominally assigned to practice public health, but these personnel receive little support, capacity development, or supervision to do so.


Our approach
Project SOAR is helping the Angolan Ministry of Health (MOH) establish a quality improvement program for the practice of public health. The four primary activities are: (1) establishing a list of essential public health functions for Angola, (2) drafting an instrument that measures performance of public health functions, (3) implementing the resulting self-assessment tool, and (4) producing a toolkit that the MOH can use to develop performance improvement plans.


The impact
The expected outcome is the transition of district health officers from being solely focused on clinical services to having tools to perform the essential public health functions of assessing health burdens and threats, mobilizing local resources and leaders around the data to inform and implement local responses, and assuring that public health operations are of high quality, especially in Angola’s most HIV-impacted districts. This project will help the Angolan health system develop and take ownership of a list of public health key performance indicators for district health care staff.