Orpe Human Rights Advocates proposes the Sustainable Systems Strengthening for Health Equity (SSS-HE) initiative to support governments, health institutions, and communities in building durable, equitable, and resilient public health systems. The project moves beyond short-term interventions by reinforcing the foundations that allow countries; particularly low-resource settings to deliver quality primary health care, protect vulnerable populations, and ensure equitable access to essential services.

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SSS-HE integrates capacity building, data-driven decision-making, community engagement, workforce development, and governance strengthening. The initiative operates through multi-level partnerships with ministries of health, district health offices, civil society, and community networks. By improving institutional capacity, empowering community leaders, and supporting evidence-based public health functions, the project ensures measurable improvements in service delivery and long-term sustainability.

In many low-income and vulnerable countries, health systems remain under-resourced, fragmented, and inequitable. Key challenges include:

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• Weak primary health care and limited access for women, children, and rural populations.

• Shortages of trained health workers, particularly in remote communities.

• Inadequate supply chain and essential medicines management resulting in chronic stockouts.

• Limited health information systems that hinder evidence-based policy decisions.

• Insufficient local capacity to maintain programs once donor funding ends.

• Fragile governance structures, poor coordination, and weak community engagement.

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These conditions result in preventable deaths, persistent inequities, and dependence on temporary external aid. A sustainable, system-wide public health strengthening approach centering local ownership and government stewardship is essential for long-term change.

If governments, health workers, and communities are equipped with skills, tools, infrastructure, and governance capacity,
and if systems for data, financing, service delivery, and accountability are strengthened,
then countries will be able to deliver equitable and quality public health services—sustainably and at scale.

Assumptions

• Governments and communities desire long-term self-reliance.

• Capacity and systems can be strengthened through training, mentorship, and institutional partnerships.

• Community participation increases accountability and improves health outcomes.

Change Pathway

1. Inputs: Technical assistance, capacity building, data systems, mentorship, multisector partnerships.

2. Outputs: Skilled workforce, functional systems, improved governance, community engagement.

3. Outcomes: Improved service delivery, efficient resource use, stronger equity frameworks.

4. Impact: Sustainable, equitable health systems that reduce preventable deaths and disparities.