Beyond the building blocks: integrating community roles into health systems frameworks to achieve health for all
Open accessAbstract
Achieving ambitious health goals—from the Every Woman Every Child strategy to the health targets of the sustainable development goals to the renewed promise of Alma-Ata of ‘health for all’—necessitates strong, functional and inclusive health systems. Improving and sustaining community health is integral to overall health systems strengthening efforts. However, while health systems and community health are conceptually and operationally related, the guidance informing health systems policymakers and financiers—particularly the well-known WHO ‘building blocks’ framework—only indirectly addresses the foundational elements necessary for effective community health. Although community-inclusive and community-led strategies may be more difficult, complex, and require more widespread resources than facility-based strategies, their exclusion from health systems frameworks leads to insufficient attention to elements that need ex-ante efforts and investments to set community health effectively within systems. This paper suggests an expansion of the WHO building blocks, starting with the recognition of the essential determinants of the production of health. It presents an expanded framework that articulates the need for dedicated human resources and quality services at the community level; it places strategies for organising and mobilising social resources in communities in the context of systems for health; it situates health information as one ingredient of a larger block dedicated to information, learning and accountability; and it recognises societal partnerships as critical links to the public health sector. This framework makes explicit the oft-neglected investment needs for community health and aims to inform efforts to situate community health within national health systems and global guidance to achieve health for all.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
An expansion of the six WHO building blocks has been proposed that highlights community-based service delivery as well as community mobilizing and organization, with attention to nontraditional health system components.
“An expansion of the six WHO building blocks has been proposed that highlights community-based service delivery as well as community mobilizing and organization, with attention to nontraditional health system components such as social capital, inter-sectoral partnerships, local governance, equitable financing, community information and data systems, and household production of health [101].”
From Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All” (2021) · cites this paper as [101]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Closing the gap in a generation: health equity through action on the social determinants of health
Marmot, M. G., Friel, S., Bell, R., Houweling, T. A. J., & Taylor, S. A. J. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61690-6 · Cited by 8,238 · see citing works
The United Nations Development Programme
Oestreich, J. E. (2017) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780190637347.003.0003 · Cited by 4,936 · see citing works
Box, G. E. P. (1976) · Journal of the American Statistical Association · doi:10.1080/01621459.1976.10480949 · Cited by 2,372 · see citing works
What works? Interventions for maternal and child undernutrition and survival
Bhutta, Z. A., Ahmed, T., Black, R. E., Cousens, S. N., Dewey, K. G., Giugliani, E. R. J., Haider, B. A., Kirkwood, B. R., Morris, S. S., Sachdev, H. S., et al. (2008) · The Lancet · doi:10.1016/s0140-6736(07)61693-6 · Cited by 2,264 · see citing works
An Analytical Framework for the Study of Child Survival in Developing Countries
Mosley, W. H., & Chen, L.-C. (1984) · Population and Development Review · doi:10.2307/2807954 · Cited by 1,490 · see citing works
Bhutta, Z. A., Das, J. K., Bahl, R., Lawn, J. E., Salam, R. A., Paul, V. K., Sankar, M. J., Blencowe, H., Rizvi, A., Chou, V. B., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60792-3 · Cited by 1,367 · see citing works
Continuum of care for maternal, newborn, and child health: from slogan to service delivery
Kerber, K. J., de Graft‐Johnson, J., Bhutta, Z. A., Okong, P., Starrs, A., & Lawn, J. E. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61578-5 · Cited by 1,001 · see citing works
Systems thinking for health systems strengthening.
de Savigny, D., & Adam, T. (2009) · Cited by 873 · see citing works
Manandhar, D. S., Osrin, D., Shrestha, B. P., Mesko, N., Morrison, J., Tumbahangphe, K. M., Tamang, S., Thapa, S., Shrestha, D., Thapa, B., et al. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17021-9 · Cited by 847 · see citing works
Social Accountability: What Does the Evidence Really Say?
Fox, J. (2015) · World Development · doi:10.1016/j.worlddev.2015.03.011 · Cited by 768 · see citing works
Effect of handwashing on child health: a randomised controlled trial
Luby, S. P., Agboatwalla, M., Feikin, D. R., Painter, J., Billhimer, W., Altaf, A., & Hoekstra, R. M. (2005) · The Lancet · doi:10.1016/s0140-6736(05)66912-7 · Cited by 748 · see citing works
Björkman, M., & Svensson, J. (2009) · Quarterly Journal of Economics · doi:10.1162/qjec.2009.124.2.735 · Cited by 739 · see citing works
Prost, A., Colbourn, T., Seward, N., Azad, K., Coomarasamy, A., Copas, A., Houweling, T., Fottrell, E., Kuddus, A., Lewycka, S., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(13)60685-6 · Cited by 645 · see citing works
Baqui, A. H., Arifeen, S. E., Darmstadt, G. L., Ahmed, S., Williams, E., Seraji, H. R., Mannan, I., Rahman, S. M. M., Shah, R., Saha, S. K., et al. (2008) · The Lancet · doi:10.1016/s0140-6736(08)60835-1 · Cited by 587 · see citing works
An analytical framework for the study of child survival in developing countries. 1984.
Mosley, W. H., & Chen, L.-C. (2003) · PubMed · Cited by 566 · see citing works
Gilmore, B., & McAuliffe, É. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-847 · Cited by 465 · see citing works
Glenton, C., Colvin, C., Carlsen, B., Swartz, A., Lewin, S., Noyes, J., & Rashidian, A. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010414.pub2 · Cited by 454 · see citing works
Salway, T. J., Bogaert, L., Rhodes, A. E., Brennan, D. J., & Gesink, D. (2016) · American Journal of Public Health · doi:10.2105/ajph.2016.303088 · Cited by 418 · see citing works
Time to initiation of breastfeeding and neonatal mortality and morbidity: a systematic review
Debes, A. K., Kohli, A., Walker, N., Edmond, K. M., & Mullany, L. C. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-s3-s19 · Cited by 390 · see citing works
Community participation: lessons for maternal, newborn, and child health
Rosato, M., Laverack, G., Grabman, L. H., Tripathy, P., Nair, N., Mwansambo, C., Azad, K., Morrison, J., Bhutta, Z., Perry, H., et al. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61406-3 · Cited by 379 · see citing works
Examining the links between community participation and health outcomes: a review of the literature
Rifkin, S. B. (2014) · Health Policy and Planning · doi:10.1093/heapol/czu076 · Cited by 369 · see citing works
Box, G. E. P. (1976) · Journal of the American Statistical Association · doi:10.2307/2286841 · Cited by 366 · see citing works
Peer Support for the Hardly Reached: A Systematic Review
Sokol, R. L., & Fisher, E. B. (2016) · American Journal of Public Health · doi:10.2105/ajph.2016.303180 · Cited by 230 · see citing works
Berman, P., Kendall, C., & Bhattacharyya, K. (1994) · Social Science & Medicine · doi:10.1016/0277-9536(94)90390-5 · Cited by 215 · see citing works
Mounier‐Jack, S., Griffiths, U. K., Closser, S., Burchett, H., & Marchal, B. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-278 · Cited by 185 · see citing works
Gillespie, A. M., Obregón, R., Asawi, R. E., Richey, C., Manoncourt, E., Joshi, K., Naqvi, S., Pouye, A., Safi, N., Chitnis, K., et al. (2016) · Global Health Science and Practice · doi:10.9745/ghsp-d-16-00226 · Cited by 185 · see citing works
Effectiveness of Breastfeeding Peer Counseling in a Low-Income, Predominantly Latina Population
Chapman, D. J., Damio, G., Young, S., & Pérez‐Escamilla, R. (2004) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.158.9.897 · Cited by 182 · see citing works
Black, R. E., Taylor, C. E., Arole, S., Bang, A., Bhutta, Z. A., Chowdhury, A. M. R., Kirkwood, B. R., Kureshy, N., Lanata, C. F., Phillips, J. F., et al. (2017) · Journal of Global Health · doi:10.7189/jogh.07.010908 · Cited by 182 · see citing works
Health systems frameworks in their political context: framing divergent agendas
van Olmen, J., Marchal, B., Damme, W. V., Kegels, G., & Hill, P. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-774 · Cited by 137 · see citing works
Maternal social capital and child nutritional status in four developing countries
Silva, M. J. D., & Trudy Harpham, C. (2006) · Health & Place · doi:10.1016/j.healthplace.2006.02.005 · Cited by 132 · see citing works
Farnsworth, S. K., Böse, K., Fajobi, O., Souza, P. P., Peniston, A., Davidson, L. L., Griffiths, M., & Hodgins, S. (2014) · Journal of Health Communication · doi:10.1080/10810730.2014.941519 · Cited by 108 · see citing works
Hofmeyr, G. J., Gülmezoglu, A. M., Novikova, N., Linder, V., Ferreira, S. R. G., & Piaggio, G. G. (2009) · Bulletin of the World Health Organization · doi:10.2471/blt.08.055715 · Cited by 107 · see citing works
Story, W. T. (2014) · Health & Place · doi:10.1016/j.healthplace.2014.03.011 · Cited by 103 · see citing works
Self-citationPrevention of postpartum hemorrhage at home birth in Afghanistan
Sanghvi, H., Ansari, N., Prata, N., Gibson, H., Ehsan, A. T., & Smith, J. M. (2010) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2009.12.003 · Cited by 102 · see citing works
Innovative financing for health: what is truly innovative?
Atun, R. A., Knaul, F. M., Akachi, Y., & Frenk, J. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61460-3 · Cited by 91 · see citing works
Perry, H. B., Morrow, M., Borger, S., Weiss, J., DeCoster, M., Davis, T., & Ernst, P. (2015) · Global Health Science and Practice · doi:10.9745/ghsp-d-15-00051 · Cited by 90 · see citing works
Self-citationHo, L., Labrecque, G., Batonon, I., Salsi, V., & Ratnayake, R. (2015) · Conflict and Health · doi:10.1186/s13031-015-0055-4 · Cited by 75 · see citing works
Ebola interventions: listen to communities
Kutalek, R., Wang, S., Fallah, M. P., Wesseh, C. S., & Gilbert, J. (2015) · The Lancet Global Health · doi:10.1016/s2214-109x(15)70010-0 · Cited by 66 · see citing works
Nationwide implementation of integrated community case management of childhood illness in Rwanda
Mugeni, C., Levine, A. C., Munyaneza, R. M., Mulindahabi, E., Cockrell, H. C., Glavis‐Bloom, J., Nutt, C. T., Wagner, C. M., Gaju, E., Rukundo, A., et al. (2014) · Global Health Science and Practice · doi:10.9745/ghsp-d-14-00080 · Cited by 66 · see citing works
A review of CARE’s Community Score Card experience and evidence
Gullo, S., Galavotti, C., & Altman, L. (2016) · Health Policy and Planning · doi:10.1093/heapol/czw064 · Cited by 66 · see citing works
Perry, H. B., Rassekh, B. M., GUPTA, S. K., Wilhelm, J. A., & Freeman, P. A. (2017) · Journal of Global Health · doi:10.7189/jogh.07.010901 · Cited by 63 · see citing works
Dahn, B., Woldermariam, A. T., Perry, H., Maeda, A., Glahn, D. V., Panjabi, R., Merchant, N., Vosburg, K., Palazuelos, D., Lu, C., et al. (2015) · doi:10.13140/rg.2.1.4865.0086 · Cited by 61 · see citing works
Omer, K., Mhatre, S., Ansari, N. M., Laucirica, J., & Andersson, N. (2008) · Patient Education and Counseling · doi:10.1016/j.pec.2008.02.018 · Cited by 58 · see citing works
George, A. S., LeFevre, A. E., Schleiff, M., Mancuso, A., Sacks, E., & Sarriot, E. (2018) · BMJ Global Health · doi:10.1136/bmjgh-2018-000811 · Cited by 57 · see citing works
Self-citationSacks, E., Swanson, R. C., Schensul, J. J., Gleave, A., Shelley, K. D., Were, M. K., Chowdhury, A. M., LeBan, K., & Perry, H. B. (2017) · International Quarterly of Community Health Education · doi:10.1177/0272684x17738089 · Cited by 56 · see citing works
Self-citationAn implementation framework for household and community integrated management of childhood illness
WINCH, P. J. (2002) · Health Policy and Planning · doi:10.1093/heapol/17.4.345 · Cited by 54 · see citing works
Perry, H. B., Morrow, M., Davis, T., Borger, S., Weiss, J., DeCoster, M., Ricca, J., & Ernst, P. (2015) · Global Health Science and Practice · doi:10.9745/ghsp-d-15-00052 · Cited by 51 · see citing works
Self-citationMarcil, L. E., Afsana, K., & Perry, H. B. (2016) · Journal of Urban Health · doi:10.1007/s11524-016-0026-0 · Cited by 46 · see citing works
Scaling Accountability through Vertically Integrated Civil Society Policy Monitoring and Advocacy
Fox, J. (2016) · Figshare · doi:10.13140/rg.2.2.22977.35687 · Cited by 46 · see citing works
Story, W. T., LeBan, K., Altobelli, L. C., Gebrian, B., Hossain, J., Lewis, J., Morrow, M., Nielsen, J. N., Rosales, A., Rubardt, M., et al. (2017) · Globalization and Health · doi:10.1186/s12992-017-0259-z · Cited by 46 · see citing works
Self-citationHoffman, S. J., Røttingen, J., Bennett, S., Lavis, J. N., Edge, J. S., & Frenk, J. (2012) · Cited by 44 · see citing works
Langston, A., Weiss, J., Landegger, J., Pullum, T., Morrow, M., Kabadege, M., Mugeni, C., & Sarriot, E. (2014) · Global Health: Science and Practice · doi:10.9745/ghsp-d-14-00067 · Cited by 35 · see citing works
Self-citationHodgins, S., Crigler, L., & Perry, H. B. (2018) · RePEc: Research Papers in Economics · Cited by 34 · see citing works
Underwood, C. R., Boulay, M., Snetro, G., Macwan’gi, M., Vijayaraghavan, J., Namfukwe, M., & Marsh, D. (2013) · International Quarterly of Community Health Education · doi:10.2190/iq.33.2.b · Cited by 28 · see citing works
George, A. S., Scott, K., Sarriot, E., Kanjilal, B., & Peters, D. H. (2016) · BMC Health Services Research · doi:10.1186/s12913-016-1859-7 · Cited by 24 · see citing works
Self-citationRodríguez, D., Shearer, J., Mariano, A. R., Juma, P. A., Dalglish, S. L., & Bennett, S. (2015) · Health Policy and Planning · doi:10.1093/heapol/czv033 · Cited by 23 · see citing works
Mwabu, G. (2010) · Cited by 18 · see citing works
Systems Thinking for Health Systems Strengthening
de Savigny, D., Adam, T., & Mookherji, S. (2009) · doi:10.13140/rg.2.1.4720.4325 · Cited by 18 · see citing works
Global Evidence for Peer Support: Humanizing Health Care
Progress, P. F., & Nclr (2014) · Cited by 14 · see citing works
Governance and Service Delivery: Practical Applications of Social Accountability Across Sectors
Wetterberg, A., Brinkerhoff, D. W., & Hertz, J. C. (2016) · doi:10.3768/rtipress.2016.bk.0019.1609 · Cited by 8 · see citing works
A cross-sectional survey on ZIKV in Honduras
Rosales, A. C., Mayorga, A. Y., Arias, A., Franz, F., Thomas, J., Huddle, J., Soto, R. J., Haynes, M., Prado, M., & Cherian, D. T. (2017) · International Journal of Health Governance · doi:10.1108/ijhg-11-2016-0053 · Cited by 8 · see citing works
Self-citationImproving Aid Effectiveness in Global Health
Beracochea, E. (2015) · Springer eBooks · doi:10.1007/978-1-4939-2721-0 · Cited by 6 · see citing works
Horton, R. C. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00679-6 · Cited by 5 · see citing works
Effectiveness in Primary Healthcare in Peru
Altobelli, L. C. (2015) · Springer eBooks · doi:10.1007/978-1-4939-2721-0_12 · Cited by 4 · see citing works
Uncivil and skewed language on civil society?
Sarriot, E., LeBan, K., Sacks, E., Sow, C., & Burgess, C. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30731-0 · Cited by 1 · see citing works
Self-citation
Flagged first, then by citations
2 of the 69 references couldn’t be matched to a known paper.
Research works printed but not linked: 10
- [7]International Conference on primary health care, 2018 Available: https://www.who.int/primary-health/conference-phc/
- [16]Health systems global symposium, 2018 Available: www.healthsystemsglobal.org/
- [25]Core group conference reports. Washington, DC; 2018 < https://coregroup.org/resources/conference-reports/>
- [26]Institutionalizing community health Conference, Johannesburg, South Africa, 2016 Available: http://www.ichc2017.org/
- [33]Murray C, Lopez A, Rodgers A, et al Chapter 5: choosing interventions to reduce specific risks. Geneva, Switzerland: World Health Organization, 2002.
- [41]Advancing community health across the continuum of care, 2015, core group, April 2015, presentation at the core group spring conference. Available: < https://coregroup.org/wp-content/uploads/media-backup/documents/Spring_Conference_2015/Spring_2015_GHPC_Booklet_Final.pdf>
- [68]Sarriot E Community health workers and health volunteers: leaving old debates behind. Huffington post. Institutionalizing community health conference Blog series. Available: https://www.huffingtonpost.com/entry/community-health-workers-health-volunteers-leaving_us_58da6bc5e4b04f2f079272f5 [Accessed 28 Apr 2017].
- [71]Weiss J 'CHW peer support groups: an alternative approach to supportive supervision lessons from the Rwanda. Kabeho Mwana child survival project. USAID presentation at the Integrated Community Case Management. (iCCM): Evidence Review Symposium, Accra, Ghana, 2014.
- [77]First global Ministerial conference on healthy lifestyles and noncommunicable disease control. Moscow, Russia: World Health Organization; 2011 https://www.who.int/nmh/publications/ncds_policy_makers_to_implement_intersectoral_action.pdf
- [90]Alma-Ata 40 Roundable group, 2018. implementing the Astana Declaration—What Alma-Ata taught us. health affairs blog. Available: https://www.healthaffairs.org/do/10.1377/hblog20181024.24072/full/ · DOI
Cited by
Sorted by citations
Global developments in social prescribing
Morse, D. F., Sandhu, S., Mulligan, K., Tierney, S., Polley, M. J., Giurca, B. C., Slade, S., Dias, S., Mahtani, K. R., Wells, L., et al. (2022) · BMJ Global Health · doi:10.1136/bmjgh-2022-008524 · Cited by 363 · see citing works
LeBan, K., Kok, M. C., & Perry, H. B. (2021) · Health Research Policy and Systems · doi:10.1186/s12961-021-00756-4 · Cited by 137 · see citing works
Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All”
Perry, H. B., Chowdhury, M., Were, M., LeBan, K., Crigler, L., Lewin, S., Musoke, D., Kok, M., Scott, K., Ballard, M., et al. (2021) · Health Research Policy and Systems · doi:10.1186/s12961-021-00755-5 · Cited by 129 · see citing works
Peer- and community-led responses to HIV: A scoping review
Ayala, G., Sprague, L., van der Merwe, L. L. A., Thomas, R. M., Chang, J., Arreola, S. G., Davis, S. L. M., Taslim, A., Mienies, K., Nilo, A., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0260555 · Cited by 122 · see citing works
Ugwu, C. N., Ugwu, O. P.-C., Alum, E. U., Eze, V. H. U., Basajja, M., Ugwu, J. N., Ogenyi, F. C., Ejemot-Nwadiaro, R. I., Okon, M. B., Egba, S. I., et al. (2025) · Medicine · doi:10.1097/md.0000000000041535 · Cited by 113 · see citing works
Health systems resilience in fragile and conflict-affected settings: a systematic scoping review
Truppa, C. T., Yaacoub, S. G., Valente, M., Celentano, G., Ragazzoni, L., & Saulnier, D. D. (2024) · Conflict and Health · doi:10.1186/s13031-023-00560-7 · Cited by 109 · see citing works
Zakumumpa, H., Rujumba, J., Kwiringira, J. N., Katureebe, C., & Spicer, N. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-5069-y · Cited by 89 · see citing works
Communities, universal health coverage and primary health care
Sacks, E., Schleiff, M., Were, M., Chowdhury, A. M., & Perry, H. B. (2020) · Bulletin of the World Health Organization · doi:10.2471/blt.20.252445 · Cited by 109 · see citing works
Self-citationPregnancy as an opportunity to prevent type 2 diabetes mellitus: FIGO Best Practice Advice
Adam, S., McIntyre, D. H., Tsoi, K. Y., Kapur, A., Ronald, C. W., Dias, S. C., Okong, P., Hod, M., Poon, L. C., Smith, G. N., et al. (2023) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.14537 · Cited by 91 · see citing works
Community-Led Monitoring: When Community Data Drives Implementation Strategies
Baptiste, S., Manouan, A., García, P., Etya’ale, H., Swan, T., & Jallow, W. (2020) · Current HIV/AIDS Reports · doi:10.1007/s11904-020-00521-2 · Cited by 53 · see citing works
Health system readiness for non-communicable diseases at the primary care level: a systematic review
Kabir, A., Karim, M. N., Islam, R. M., Romero, L., & Billah, B. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-060387 · Cited by 77 · see citing works
Khatri, R. B., Endalamaw, A., Erku, D., Wolka, E., Nigatu, F., Zewdie, A., & Assefa, Y. A. (2024) · BMC Family Practice · doi:10.1186/s12875-024-02629-5 · Cited by 67 · see citing works
World Health Organization building blocks in rural community health services: An integrative review
Stockton, D. A., Fowler, C., Debono, D. S., & Travaglia, J. (2021) · Health Science Reports · doi:10.1002/hsr2.254 · Cited by 56 · see citing works
The Lancet Commission on peaceful societies through health equity and gender equality
Percival, V., Thoms, O. T., Oppenheim, B., Rowlands, D., Chisadza, C., Fewer, S., Yamey, G., Alexander, A. C., Allaham, C. L., Causevic, S., et al. (2023) · The Lancet · doi:10.1016/s0140-6736(23)01348-x · Cited by 55 · see citing works
Léger, A., Lambraki, I. A., Graells, T., Cousins, M., Henriksson, P. J. G., Harbarth, S., Carson, C. A., Majowicz, S. E., Troell, M. F., Parmley, E. J., et al. (2020) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkaa394 · Cited by 52 · see citing works
Ryneveld, M. V., Whyle, E. B., & Brady, L. (2020) · International Journal of Health Policy and Management · doi:10.34172/ijhpm.2020.167 · Cited by 48 · see citing works
Basu, A., Kuziemsky, C. E., Novaes, M. D. A., Kleber, A., Sales, F. J. R., Al-Shorbaji, N., Florez-Arango, J. F., Gogia, S. B., Ho, K., Hunter, I. M., et al. (2021) · Yearbook of Medical Informatics · doi:10.1055/s-0041-1726484 · Cited by 43 · see citing works
Borghi, J., & Brown, G. W. (2022) · Global Policy · doi:10.1111/1758-5899.13081 · Cited by 41 · see citing works
Naser, K., Haq, Z. U., & Naughton, B. D. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21040434 · Cited by 38 · see citing works
The Multiple Lenses on the Community Health System: Implications for Policy, Practice and Research
Schneider, H. M., Olivier, J., Orgill, M., Brady, L., Whyle, E. B., Zulu, J. M., Sebastiån, M. S., & George, A. S. (2021) · International Journal of Health Policy and Management · doi:10.34172/ijhpm.2021.73 · Cited by 36 · see citing works
Khatri, R. B., Endalamaw, A., Erku, D., Wolka, E., Nigatu, F., Zewdie, A., & Assefa, Y. A. (2025) · PLoS ONE · doi:10.1371/journal.pone.0318244 · Cited by 35 · see citing works
Mulupi, S., Ayakaka, I., Tolhurst, R., Kozak, N., Shayo, E. H., Abdalla, E., Osman, R., Egere, U., Mpagama, S. G., Chinouya, M. J., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-052105 · Cited by 34 · see citing works
Heine, M., Lupton-Smith, A. R., Pakosh, M. T., Grace, S. L., Derman, W. E., & Hanekom, S. D. (2019) · BMJ Global Health · doi:10.1136/bmjgh-2019-001833 · Cited by 31 · see citing works
Grandparent caregiving in Cambodian skip-generation households: Roles and impact on child nutrition.
Schneiders, M. L., Phou, M., Tum, V., Kelley, M., Parker, M., & Turner, C. (2021) · Maternal & Child Nutrition · doi:10.1111/mcn.13169 · Cited by 29 · see citing works
“, 2000), and provide data in support of the HHPH framework (Berman et al., 1994; Sacks et al., 2019).”
BackgroundColombini, M., Mayhew, S., García‐Moreno, C., d’Oliveira, A. F. P. L., Feder, G. S., & Bacchus, L. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08826-1 · Cited by 33 · see citing works
Briggs, A. M., Sumi, Y., & Banerjee, A. (2025) · Global Health Research and Policy · doi:10.1186/s41256-025-00426-w · Cited by 28 · see citing works
Reyes, A., Serafica, R., Kawi, J., Fudolig, M., Sy, F., Leyva, E. W., & Evangelista, L. (2023) · Asian/Pacific Island Nursing Journal · doi:10.2196/45669 · Cited by 30 · see citing works
Putting health workers at the centre of health system investments in COVID-19 and beyond
Deussom, R. H., Lal, A., Frymus, D. E., Cole, K., Politico, M. R., Saldaña, K., Vasireddy, V., Khangamwa, G., & Jaskiewicz, W. (2022) · Family Medicine and Community Health · doi:10.1136/fmch-2021-001449 · Cited by 26 · see citing works
Simen-Kapeu, A., Reserva, M. E., & Ekpini, R. E. (2021) · Global Health Science and Practice · doi:10.9745/ghsp-d-20-00377 · Cited by 25 · see citing works
Al-Waziza, R., Sheikh, R., Ahmed, I., Al-Masbhi, G., & Dureab, F. A. (2023) · Discover Health Systems · doi:10.1007/s44250-023-00026-w · Cited by 24 · see citing works
Doshmangir, L., Sanadghol, A., Kakemam, E., & Majdzadeh, R. (2025) · PLoS ONE · doi:10.1371/journal.pone.0315592 · Cited by 30 · see citing works
Resilience Testing of Health Systems: How Can It Be Done?
Rogers, H. L., Barros, P. P., Maeseneer, J. D., Lehtonen, L., Lionis, C. D., McKee, M., Siciliani, L., Stahl, D., Zaletel, J., & Kringos, D. S. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18094742 · Cited by 23 · see citing works
Motivation and Performance of Community Health Workers: Nothing New Under the Sun, and Yet…
Sarriot, E., Davis, T., Morrow, M., Kabore, T., & Perry, H. B. (2021) · Global Health Science and Practice · doi:10.9745/ghsp-d-21-00627 · Cited by 27 · see citing works
Self-citationOperationalising health systems thinking: a pathway to high effective coverage
Vaz, L. M. E., Franco, L. M., Guenther, T., Simmons, K., Herrera, S., & Wall, S. N. (2020) · Health Research Policy and Systems · doi:10.1186/s12961-020-00615-8 · Cited by 20 · see citing works
Obi, C., Ojiakor, I., Etiaba, E., & Onwujekwe, O. E. (2024) · International Journal of Public Health · doi:10.3389/ijph.2024.1606810 · Cited by 19 · see citing works
Mulderij-Jansen, V. I. C., Gerstenbluth, I. I., Duits, A. J., Tami, A., & Bailey, A. (2021) · Parasites & Vectors · doi:10.1186/s13071-021-05011-x · Cited by 18 · see citing works
Health System Performance and Resilience in Times of Crisis: An Adapted Conceptual Framework
Poroes, C., Seematter‐Bagnoud, L., Wyss, K., & Peytremann‐Bridevaux, I. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20176666 · Cited by 21 · see citing works
Ayanore, M. A., Asampong, R., Akazili, J., Awoonor‐Williams, J. K., & Akweongo, P. (2022) · PLoS ONE · doi:10.1371/journal.pone.0269546 · Cited by 16 · see citing works
Marshall, J. T., Scott, B., Delva, J., Ade, C., Hernández‐Bojorge, S., Patel, J., Moreno-Cheek, M., Rojas, D., Tanner, J.-P., & Kirby, R. S. (2020) · Maternal and Child Health Journal · doi:10.1007/s10995-020-02969-5 · Cited by 16 · see citing works
Zulu, J. M., Chavula, M. P., Silumbwe, A., Munakampe, M. N., Mulubwa, C., Zulu, W., Michelo, C., Schneider, H. M., & Lehmann, U. (2021) · International Journal of Health Policy and Management · doi:10.34172/ijhpm.2021.145 · Cited by 15 · see citing works
Optimising scale and deployment of community health workers in Sierra Leone: a geospatial analysis
Oliphant, N. P., Ray, N., Curtis, A., Musa, E., Sesay, M., Kandeh, J., Kamara, A. R. Y., Hassen, K., O’Connor, S., Suehiro, Y., et al. (2022) · BMJ Global Health · doi:10.1136/bmjgh-2021-008141 · Cited by 15 · see citing works
Baliolaa, M. Y. T., Golpe, M. R., & Advincula-Lopez, L. V. (2023) · Journal of Health Research · doi:10.56808/2586-940x.1060 · Cited by 15 · see citing works
Bertone, M. P., Palmer, N., Kruja, K., Witter, S., & HSSEC Working Group 1 (2022) · The International Journal of Health Planning and Management · doi:10.1002/hpm.3607 · Cited by 14 · see citing works
Tales of treatment and new perspectives for global health research on antimicrobial resistance
Haenssgen, M. J., Charoenboon, N., Thavethanutthanawin, P., & Wibunjak, K. (2020) · Medical Humanities · doi:10.1136/medhum-2020-011894 · Cited by 16 · see citing works
Building leadership and managerial capacity for maternal and newborn health services
Murphy, G. T., Mtey, G., Nyamtema, A., LeBlanc, J. C., Rigby, J. A., Abel, Z., & Mselle, L. T. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08448-7 · Cited by 14 · see citing works
Terminology for Dissemination and Implementation Research
Rabin, B. A., Viglione, C., & Brownson, R. C. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780197660690.003.0002 · Cited by 14 · see citing works
Hutchinson, E., Mundua, S., Ochero, L., Mbonye, A. K., & Clarke, S. E. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.113941 · Cited by 14 · see citing works
Tran, N. T., Meyers, J., Malilo, B., Chabo, J., Muselemu, J.-B., RIZIKI, B., LIBONGA, P., Shire, A. H., Had, H., Ali, M. M., et al. (2021) · Frontiers in Global Women s Health · doi:10.3389/fgwh.2021.671058 · Cited by 13 · see citing works
Omar, M. A. (2021) · Somali Health Action Journal · doi:10.36368/shaj.v1i1.250 · Cited by 13 · see citing works
Slater, H., & Briggs, A. M. (2024) · Pain · doi:10.1097/j.pain.0000000000003373 · Cited by 13 · see citing works
COVID-19, climate change, and communities
Sacks, E., Yangchen, S., & Marten, R. (2021) · The Lancet Planetary Health · doi:10.1016/s2542-5196(21)00257-6 · Cited by 13 · see citing works
Self-citationOliphant, N. P., Sy, Z., Koné, B., Berthé, M., Beebe, M., Samaké, M., Diabaté, M., Tounkara, S., Diarra, B., Diarra, A. B., et al. (2022) · PLOS Global Public Health · doi:10.1371/journal.pgph.0000626 · Cited by 11 · see citing works
Jacobs, C. N., Musukuma, M., Sikapande, B., Chooye, O., Wehrmeister, F. C., Boerma, T., Michelo, C., & Blanchard, A. K. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-09086-3 · Cited by 11 · see citing works
Haenssgen, M. J., Elliott, E. M., Phommachanh, S., Phomkong, S., Kounnavong, S., & Kubota, S. (2024) · BMJ Global Health · doi:10.1136/bmjgh-2023-014640 · Cited by 11 · see citing works
Karim, A., de Savigny, D., Awor, P., Muñoz, D. C., Mäusezahl, D., Tshefu, A. K., Ngaima, S., Enebeli, U. U., Isiguzo, C., Nsona, H., et al. (2022) · BMJ Global Health · doi:10.1136/bmjgh-2022-008493 · Cited by 11 · see citing works
van Pinxteren, M., Colvin, C., & Cooper, S. (2022) · PLOS Global Public Health · doi:10.1371/journal.pgph.0000664 · Cited by 5 · see citing works
Towards healthy populations: A need to strengthen systems for musculoskeletal health
Briggs, A. M., Betteridge, N., Dreinhöfer, K., Haq, S. A., Schneider, C. H., Kalla, A. A., Kopansky-Giles, D. R., MARCH, L. M., Sharma, S., Soriano, E. R., et al. (2022) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2022.152147 · Cited by 10 · see citing works
Mbuthia, F. W., Reid, M., & Fichardt, A. (2021) · International Journal of Africa Nursing Sciences · doi:10.1016/j.ijans.2021.100304 · Cited by 9 · see citing works
Kananura, R. M., Birabwa, C., Ssanyu, J. N., Kizito, F., Kagaha, A., Namutanba, S., Kyangwa, M., Kakaire, O., & Waiswa, P. (2024) · PLoS ONE · doi:10.1371/journal.pone.0293351 · Cited by 8 · see citing works
Pillay, Y. G. (2022) · South African Journal of Psychology · doi:10.1177/00812463221083062 · Cited by 9 · see citing works
Li, C., Zhang, Y. S., Noppert, G. A., Hazzouri, A. Z. A., Gross, A. L., & Kobayashi, L. C. (2024) · SSM - Population Health · doi:10.1016/j.ssmph.2024.101716 · Cited by 8 · see citing works
Legal and institutional foundations for universal health coverage, Kenya
Mbindyo, R. M., Kioko, J., Siyoi, F., Cheruiyot, S., Wangai, M., Onsongo, J. K., Omwoyo, A., Kisia, C., & Miriti, K. (2020) · Bulletin of the World Health Organization · doi:10.2471/blt.19.237297 · Cited by 7 · see citing works
Kiendrébéogo, J. A., Sory, O., Kaboré, I., Kafando, Y., Steege, R., George, A. S., & Kumar, M. B. (2024) · Global Health Action · doi:10.1080/16549716.2024.2407680 · Cited by 7 · see citing works
Interventions to improve the quality of cataract services: protocol for a global scoping review
Yoshizaki, M., Ramke, J., Furtado, J. M., Burn, H., Gichuhi, S., Gordon, I., Aghaji, A. E., Marques, A. P., Dean, W. H., Congdon, N. G., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-036413 · Cited by 7 · see citing works
Tran, N. T., Greer, A., Kini, B., Abdi, H., Rajeh, K., Cortier, H., & Boboeva, M. (2020) · Conflict and Health · doi:10.1186/s13031-020-00326-5 · Cited by 7 · see citing works
Story, W. T., Pritchard, S., Hejna, E. E., Olivas, E., & Sarriot, E. (2020) · Health Policy and Planning · doi:10.1093/heapol/czaa177 · Cited by 7 · see citing works
Self-citationMichelo, C., Hurtig, A., & Schneider, H. M. (2021) · International Journal of Health Policy and Management · doi:10.34172/ijhpm.2021.166 · Cited by 7 · see citing works
Levels of engagement in participatory health systems strengthening: A systematic literature review
Marinus, J. D., la Roi, C., & Boerma, E. C. (2024) · Social Sciences & Humanities Open · doi:10.1016/j.ssaho.2024.101246 · Cited by 9 · see citing works
Yahner, M., Muriuki, A., Mangieri, A., Nitu, S. N. A., Shafinaz, S., & Sarriot, E. (2022) · Global Health Science and Practice · doi:10.9745/ghsp-d-22-00023 · Cited by 6 · see citing works
Self-citationEtiaba, E., Agwu, P., Conteh, L., & Onwujekwe, O. E. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1505383 · Cited by 6 · see citing works
Kinney, R. G., Zakumumpa, H., Rujumba, J., Gibbons, K., Heard, A. C., & Galárraga, O. (2021) · Global Health Action · doi:10.1080/16549716.2021.1988280 · Cited by 6 · see citing works
van Immerzeel, T. D., Diagne, M., Ly, I. D., Murungi, A. E., Diouf, S., Kerac, M., Grijalva-Eternod, C. S., & Day, L. T. (2022) · Maternal and Child Nutrition · doi:10.1111/mcn.13455 · Cited by 6 · see citing works
Haenssgen, M. J., Elliott, E. M., Bode, S., Souksavanh, O., Xayyahong, T., Okabayashi, H., & Kubota, S. (2025) · Global Health Action · doi:10.1080/16549716.2025.2485523 · Cited by 5 · see citing works
Apers, H., & Masquillier, C. (2024) · Healthcare · doi:10.3390/healthcare12232348 · Cited by 5 · see citing works
D’Apice, C., Ghirotto, L., Bassi, M. C., Artioli, G., & Sarli, L. (2022) · Journal of Global Health · doi:10.7189/jogh.12.04035 · Cited by 5 · see citing works
Kumar, A., Tiwari, M., Krishna, R., Singh, P. K., Sahu, A., Singh, V. K., Mishra, A., Kumar, P. M., Kumar, A., Darmstadt, G. L., et al. (2022) · Acta Paediatrica · doi:10.1111/apa.16534 · Cited by 5 · see citing works
Community Health Systems Management and Governance
Kapologwe, N., Kalolo, A., Kengia, J. T., Swai, I. L., Kesale, A. M., Kacholi, G., Jiyenze, M. K., & Anasel, M. G. (2023) · CRC Press eBooks · doi:10.1201/9781003346821-8 · Cited by 5 · see citing works
Gurung, D., Subedi, B., Kohrt, B. A., Wahid, S. S., Rai, S., Thornicroft, G., & Gronholm, P. C. (2025) · PLoS ONE · doi:10.1371/journal.pone.0316999 · Cited by 7 · see citing works
Integrating COVID-19 vaccination into health systems: qualitative findings from seven countries
Touré, C., Makinen, M., Almiñana, A., Chee, G., Kanagat, N., Fields, R., Kudrati, S. Z., Hatt, L. E., Ewald, L., Amoussou, A. S. E., et al. (2025) · BMJ Global Health · doi:10.1136/bmjgh-2024-017035 · Cited by 4 · see citing works
Amitha, K., Rahul, A., Choolayil, A. C., & Moosan, H. (2025) · Journal of Public Health Policy · doi:10.1057/s41271-025-00565-x · Cited by 4 · see citing works
Spanakis, M., Stamou, M., Boultadaki, S., Liantis, E., Lionis, C. D., Marinos, G., Mariolis, A. D., Matthaiou, A. Μ., Mihas, C. C., Mouchtouri, V. Α., et al. (2025) · Healthcare · doi:10.3390/healthcare13141706 · Cited by 4 · see citing works
A collaboration team to build social service partnerships within a safety-net health system
Carson, S. L., Cameron, F., Lee, D., Zúñiga, D., Poole, K. J., Jones, A., Herman, C., Ramírez, M. R. L., Harlow, S., Johnson, J. L., et al. (2024) · BMC Public Health · doi:10.1186/s12889-024-18155-z · Cited by 4 · see citing works
Implementasi Program Keluarga Harapan di Kelurahan Sawah Baru Kota Tangerang Selatan
Firmansyah, D. (2023) · Sosial Budaya · doi:10.24014/sb.v20i2.27583 · Cited by 4 · see citing works
Health system description and assessment: a scoping review of templates for systematic analyses
Waitzberg, R., Pfundstein, I., Maresso, A., Rechel, B., van Ginneken, E., & Quentin, W. (2024) · Health Research Policy and Systems · doi:10.1186/s12961-024-01166-y · Cited by 4 · see citing works
Odii, A., Etiaba, E., & Onwujekwe, O. E. (2024) · BMJ Global Health · doi:10.1136/bmjgh-2023-014610 · Cited by 4 · see citing works
Jafari, H. S., Mousavi, S. M., Ghoshouni, H., Nemati, M., & Kelishadrokhi, S. F. (2023) · Disaster and Emergency Medicine Journal · doi:10.5603/demj.a2022.0024 · Cited by 4 · see citing works
Bharani, S., Liu, H., Borah, R. R., Sheeladevi, S., & Keay, L. J. (2021) · Ophthalmic and Physiological Optics · doi:10.1111/opo.12815 · Cited by 4 · see citing works
Giusti, A., Pukrittayakamee, P., Wannarit, K., Thongchot, L., Janwanishstaporn, S., Nkhoma, K. B., Venkatapuram, S., & Harding, R. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-11922-z · Cited by 3 · see citing works
Farje-Gallardo, C. A., Salazar, O. P., & Coronel-Zubiate, F. T. (2025) · BMC Oral Health · doi:10.1186/s12903-025-05711-1 · Cited by 3 · see citing works
Conway, A., Grebely, J., Treloar, C., Matthews, S. J., Lafferty, L., Taylor, N., Fontaine, G., & Marshall, A. D. (2025) · Journal of Viral Hepatitis · doi:10.1111/jvh.70080 · Cited by 3 · see citing works
Leadership and Governance in Primary Healthcare
Kapologwe, N., Anasel, M. G., & Kalolo, A. (2023) · CRC Press eBooks · doi:10.1201/9781003346821 · Cited by 3 · see citing works
Gitaka, J., Mbugua, S. M., Mwaura, P., Gatungu, D., Githanga, D. P., Ndwiga, C., Abuya, T., K’Oduol, K., Liambila, W., & Were, F. (2022) · PLOS Global Public Health · doi:10.1371/journal.pgph.0000183 · Cited by 3 · see citing works
Introduction to Primary Health Care
Kapologwe, N., Sichalwe, A., & Kalolo, A. (2023) · CABI eBooks · doi:10.1079/9781800623330.0001 · Cited by 3 · see citing works
Namukose, S., Kiwanuka, S. N., Makumbi, F. E., & Maina, G. W. (2023) · PLoS ONE · doi:10.1371/journal.pone.0289389 · Cited by 3 · see citing works
Social Prescribing: Healing People Through Community
Kuhn, A. L. R., & Rariden, C. A. (2024) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2023.104894 · Cited by 3 · see citing works
Local Health Service Response to COVID-19 in Mexico: Notes From an Exploratory Qualitative Study
Gutiérrez-Alba, G., Hernández, J. A. M., Juárez‐Ramírez, C., Reartes-Peñafiel, D. L., & Reyes‐Morales, H. (2024) · Health Education & Behavior · doi:10.1177/10901981241230492 · Cited by 3 · see citing works
Ogbewele, E. G., Mbata, A. O., & Nwosu, N. T. (2024) · International Journal of Applied Research in Social Sciences · doi:10.51594/ijarss.v6i10.1641 · Cited by 3 · see citing works
Aboulhallaj, M., Mousavi, S. M., Jafarı, M., Vosoogh‐Moghaddam, A., Bahariniya, S., Ghasemyani, S., & Far, S. S. T. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-11887-z · Cited by 3 · see citing works
Ousman, K. B., Thumath, M., McKay, G., Niyukuri, D., Ombeni, D. M., Kabego, L., Banzua, B., Mangala, S., Tatabod, R., Mirindi, P. N., et al. (2022) · Journal of Global Health Reports · doi:10.29392/001c.36558 · Cited by 2 · see citing works
Isangula, K. G., Usiri, A. I., & Pallangyo, E. (2024) · JMIR Research Protocols · doi:10.2196/54323 · Cited by 2 · see citing works
- Authors
- Sacks, E., Morrow, M., Story, W. T., Shelley, K. D., Shanklin, D., Rahimtoola, M., Rosales, A., Ibe, O., & Sarriot, E.
- Affiliations
- Johns Hopkins University (US)
- United States Agency for International Development (US)
- University of Iowa (US)
- Program for Appropriate Technology in Health (US)
- CORE Inc, Washington, District of Columbia, USA
- Independent Health Systems Consultant, Boston, Massachusetts, USA
- World Vision (US)
- Save the Children (US)
- Corresponding author
- Sacks, Emma
- Venue
- BMJ Global Health
- Publisher
- BMJ
- Published
- 2019-06
- Volume
- 3
- Issue
- Suppl 3
- Pages
- e001384
- ISSN
- 2059-7908 (ISSN-L)
- PMC
- PMC6591791
- OpenAlex
- W2952783822
- Cited by
- 203
- References
- 69
- Citations by year
- 2026: 32 · 2025: 30 · 2024: 36 · 2023: 28 · 2022: 27 · 2021: 34 · 2020: 15 · 2019: 1
- Type
- conference abstract
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Global Health (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- USAID / Maternal and Child Survival Program (Cooperative Agreement AID-OAA-A-14-00028)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Practices
- Health Sciences › Health Professions › General Health Professions › Community Health and Development
- Social Sciences › Economics, Econometrics and Finance › Finance › Healthcare Systems and Reforms
- Keywords
- community health, health system strengthening, health for all, community health workforce, community-based care, social mobilization, health information systems, accountability, health care financing, Sustainable Development Goals, Almaty
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
