Flagship Course in Health System Reform

The Flagship Course on Health System Strengthening and Sustainable Financing has over two decades of continued experience as a global, regional and national capacity building program. In this time period, the course has reached over 20,000 participants and remains highly demanded by national governments and donor agencies.

This training course on health systems performance began in 1995, when several bilateral donors requested the World Bank to develop a capacity-building program for low- and middle-income countries to address an increasing interest in health sector and financing reforms. Over the next two years, the World Bank worked with a number of research institutions, including the Harvard School of Public Health, to build a program that was country-focused and was not ideological or prescriptive in nature. The resulting program has provided a global course held annually in Washington, DC; regional courses in all six major geographical regions served by the World Bank; and senior policy seminars and country-specific courses on selected themes, with a recent focus for many courses on Universal Health Coverage.

As global experience with health systems reforms accumulated, the Flagship Course has been updated and revised to reflect the growing knowledge base. This process has contributed to the continued demand for this learning program. Over time, the Flagship Course and its approach have been adopted and adapted by other health and development agencies, including USAID, WHO, the Global Fund to Fight AIDS, Tuberculosis and Malaria, GAVI, and the Bill & Melinda Gates Foundation.

For a review of experience with the Flagship Course, see this article in Health Systems & Reform.

On July 9 and 10, 2018, USAID’s Health Finance and Governance (HFG) project, in partnership with the World Bank, organized a Workshop on the Flagship Learning Program for the Next Decade in Washington, DC. The workshop was attended by 33 persons from 15 organizations prominent in health and development. The meeting marked an important milestone in twenty years of delivering the Flagship Course on Health System Strengthening and Sustainable Financing. The workshop provided a unique space for instructors, sponsors, and other thought leaders to reflect on how to update the Flagship Course for the next decade.

The workshop resulted in a productive set of discussions and proposals to revise and update the Flagship Learning Program moving forward. It also provided a valuable opportunity for sharing the history of the course’s development with the younger generation of course instructors.

Over two days, workshop participants engaged in discussions about what has worked and what has not worked, proposed revisions to the learning program, and explored what is needed to ensure the program’s sustainability. Focused discussions on specific sessions from the course resulted in the identification of areas for improvement in analytical methods, teaching objectives, and teaching methods including cases.

There was broad agreement among workshop attendees that the Flagship Program continues to be a valuable capacity-building and knowledge-transfer mechanism for health system actors. A key insight from the workshop was that the Flagship Learning Program has created a global Flagship community.

A summary of the workshop’s discussions and decisions can be found here. Follow-up discussions will be held to continue the momentum in updating the course.

After the workshop, HFG supported seven experts to build on recommendations for revising content of the Flagship Learning Program. Professor Michael R. Reich led this initiative and provided oversight to authors who prepared materials that can be used to revise the Flagship Learning Program. The authors and products are listed in Table 1 below. The materials include synthesis reports on health system strengthening topics, updated and new course content to be used in future Flagship courses, and a glossary of terms used in the Flagship Program.

At the conclusion of the HFG project, on September 28, 2018, these materials were in various stages of completion: some were ready to use in upcoming Flagship Courses, while others were still drafts that require additional development prior to wider dissemination and use. The meeting concluded with the hope that additional Flagship Learning Program materials will be completed and disseminated, for use in future Flagship Courses and other educational activities.