Common drivers of high-performing public health programs revealed

The highest performing countries across public health outcomes share many drivers that contribute to their success. That's the conclusion of a new study published May 9 in the open-access journal PLOS Global Public Health by Dr. Nadia Akseer, an Epidemiologist-Biostatistician at Johns Hopkins Bloomberg School of Public Health and co-author of the study and colleagues in the Exemplars in Global Health (EGH) program.

In recent years, the EGH program has begun to identify and study positive outliers when it comes to global health programs around the world, with an aim of uncovering not only which health interventions work, but also how they have been successfully delivered. The identified outliers have had exceptional success relative to the economic status of the countries in which they take place.

In the new study, the researchers systematically analyzed 31 previous EGH studies across six topics, including under-five child mortality, childhood stunting, community health workers (CHW), vaccine delivery, COVID-19 response, and newborn and maternal mortality reduction. The studies included data from 19 countries in Africa, Latin America, Asia, and the Caribbean. The EGH team looked for common themes and findings in these countries that resulted in programmatic success.

In general, the drivers that were seen most often in EGH positive outliers could be grouped into eight themes: efficient data systems, effective leadership, effective stakeholder coordination, a capacitated workforce, intentional women's empowerment, a conducive national policy environment, sustainable financing, and outreach. These themes align with previous efforts aimed at identifying drivers of global health improvements and with the World Health Organization's Health Systems Framework.

The authors say that the new findings reinforce a set of cross-cutting principles that should influence national health policies and strategies. "We hope that by summarizing the common factors among the countries who have been able to maximize impact, findings from this study can aid funders, policymakers, and other stakeholders in understanding strategies to achieve optimal outcomes across health and human development," they write.

In analyzing 19 countries globally, Exemplars in Global Health found that those achieving some of the greatest progress in public health all focused on similar priorities. By sharing key lessons on how they improved, our hope is that we can help country leaders, funders, and global partners craft evidence-based policies that best allocate resources-; and, in doing so, enhance health outcomes around the world."

Dr. Nadia Akseer, Epidemiologist-Biostatistician, Johns Hopkins Bloomberg School of Public Health