African Health Initiative
The African Health Initiative (AHI) seeks to catalyze significant advances in strengthening health systems by supporting partnerships that will design, implement and evaluate large-scale models of care that link implementation research and workforce training directly to the delivery of integrated primary healthcare in sub-Saharan Africa.
Putting health systems first—strengthening the entire foundational health system with an integrated network of learning, approaches and solutions—is essential to saving lives. It is with this understanding that the Doris Duke Charitable Foundation crafted the strategy for the African Health Initiative. Learn about the three components we see as critical to the success of any effort by a funder to strengthen a health system, read related research and watch videos that demonstrate what this work looks like in powerful practice.Learn More
AHI’s second phase draws from lessons learned through AHI Phase 1 and responds to the continued need to strengthen health systems in sub-Saharan Africa with the more specific goal of improving maternal and neonatal survival and well-being. Given this objective, in AHI Phase 2, the foundation will support up to four large-scale health system strengthening partnerships that: 1) replicate, evaluate and scale up interventions that achieve measurable, significant health improvements, and 2) develop national, regional and/or district-level platforms that use existing health and implementation research to enable the entire health system to become more responsive to the population’s changing contexts and needs. Unique to AHI Phase 2 is its structure of leadership uniting national ministries of health, U.S. and African universities and research centers, and global funders contributing to the same model and measures for success. Additionally, as was done in AHI Phase 1, grantees will convene regularly to share their progress and findings and coordinate with other learning networks to ensure broader progress across the region.
During the first phase of the African Health Initiative, the foundation selected five teams from four institutions to implement proof-of-concept projects that would test a variety of health systems strengthening interventions over five to seven years. These teams also trained local staff on how to conduct implementation research as a way to build and sustain health systems that were robust and responsive to new and ongoing health challenges on the ground. Each Phase 1 project was required to collect data showing whether or not their interventions resulted in measurable impacts on population health and to make that data publicly available to country leaders and the broader field.
About the African Health Initiative
As DDCF approached its 10th anniversary, the foundation's board challenged the staff to identify a compelling and urgent need that fit the mandate of Doris Duke’s will, and for which a well-timed and large infusion of the foundation’s resources (above and beyond its normal grant-making activities) had the potential to make a significant positive impact on society. Seeing the board’s challenge as an opportunity to build upon and expand beyond the foundation’s previous support for AIDS research in Africa, the Medical Research Program sought to identify opportunities for DDCF to help address health disparities in Africa more broadly.
Extensive research and interviews with dozens of experts revealed that despite the recent growth of health investments in Africa, efforts to improve access to essential medical care remain seriously hindered by fragile health systems, health worker shortages and a lack of focus on integrated care. In response to these challenges, DDCF launched the multi-million dollar African Health Initiative in the fall of 2007. In 2009, four grants ranging from $8 million to $15 million each to support five Population Health Implementation & Training (PHIT) partnerships working in Ghana, Mozambique, Rwanda, Tanzania and Zambia. All PHIT projects, which were funded over five to seven years, remain in progress. The African Health Initiative does not accept unsolicited requests for funding.
Below is a video, courtesy of the World Bank, which illustrates the impetus of the African Health Initiative's work to strengthen health systems:
- The World Health Organization Alliance for Health Policy and Systems Research released the first World Report on Health Policy and Systems Research in May 2017.
- The 4th Global Symposium on Health Systems Research was held on November 14-18, 2016 in Vancouver, Canada. A summary of the key themes and outcomes from the meeting is available here.
- An editorial in the February 2017 World Health Organization Bulletin promoted the strengthening of health systems through embedded research.
- The 3rd Global Symposium on Health Systems Research was held on September 29-October 3, 2014 in Cape Town, South Africa. A summary of the key themes and outcomes from the meeting is available here.
- A comment in the Lancet advocated for donor support of the NGO Code of Conduct.
- The Council on Health Research for Development (COHRED) released new guidance for fair research contracting.
- The Insitute of Medicine (IOM) released the report, "Evaluation Design for Complex Global Initiatives," which summarized the January workshop.
- PHIT Data Collaborative Concept Paper (447 KB PDF)
What We're Learning
- "The African Health Initiative Presents Its Baseline Data" Lola Adedokun, M.P.H., Director for the African Health Initiative and Program Director for the Child Well-being Program
- "The African Health Initiative on Understanding Implementation" Mary Travis Bassett, M.D., M.P.H., Former Program Director of the African Health Initiative
- "Early Lessons from the African Health Initiative" Mary Travis Bassett, M.D., M.P.H., Former Program Director of the African Health Initiative