Integrated Health Systems Strengthening and Service Delivery (IHSS-SD)

Country: Pakistan

Client(s): USAID/Pakistan

Services: Technical Assistance, Capacity Development

Technical Expertise: Family Planning & Reproductive Health, Maternal Health, Health Systems Strengthening


In 2010, Pakistan decentralized its health system to give more responsibility to provincial governments for policy-setting and service delivery. "Devolution" was a major paradigm shift and required provincial health systems to make substantial structural and fiscal adjustments to be in line with the new legislation.

The Integrated Health Systems Strengthening and Service Delivery (IHSS-SD) Activity is a three-year, USAID-funded initiative to assist Pakistan with further consolidating and strengthening its post-devolution health system at the federal, provincial, district, and community levels.

IHSS-SD builds on a previous USAID-funded health systems strengthening project, also managed by JSI, that worked at the federal level and at the provincial and district level in Sindh Province. IHSS-SD will continue working at the federal level, provide assistance to consolidate the HSS gains made in Sindh province during the previous project, and begin working in Khyber Pakhtunkhwa (KP) province to strengthen its health system and public and private sector service delivery mechanisms.

The activity will work across the four levels of Pakistan’s health system to: 1) Apply federal health standards to all provinces; 2) Provide technical assistance to provinces to improve their abilities to carry out health systems strengthening work; and 3) Document public and private sector health systems- and service delivery-strengthening results in two districts to show how they can be scaled-up and replicated in other districts.