How We Work

Why Systems? Which Systems?

Pathfinder's overarching goal of improving sexual and reproductive health is only achievable by addressing a range of systemic challenges that underlie the demand for, and delivery of, health care.

Pathfinder's work to improve sexual and reproductive health is fundamentally about improving how systems-both a community system and the formal health system-work for the people we serve. For this reason, Pathfinder's work to improve sexual and reproductive health is fundamentally about improving how systems-both a community system and the formal health system-work for the people we serve. The idea of a "system" can be challenging to grasp. On the formal health system side, this can include standards and protocols, government priorities, facilities, medical curricula, staffing, commodities management, and other areas that ensure demand is met when services are provided. In terms of the community system, this can include the capacity of women and men to identify community-level, as well as individual health, problems, address health risks, and coalesce around local structures and leadership.

The relative strength of these systems can deeply affect a family's health and the communities' well-being. Too often, systems in countries where we work are plagued by community feelings of helplessness or disenfranchisement, weaknesses in managerial capacity, misallocation of resources, and poor quality services that do not match community needs. Imagine, a woman coming to a clinic only to find it has run out of the type of contraceptive she seeks, or a man visiting with a doctor and realizing the doctor is untrained in the service he needs. Or what of a community in which cultural norms are at odds with an individual's decision to seek family planning services?

Although health and community systems form the foundation of health care in the countries where we work, they are frequently addressed in isolation from each other. While much governmental, donor, and NGO attention is paid to the formal health system of hospitals, clinics, and health posts and the human and material resources needed to make them function, the focus on communities can sometimes be lacking. Pathfinder works with the formal health system and we are also mindful of our roots in community action and the community systems that shape goal-setting and decision-making. For this reason, Pathfinder focuses on what we call a "zone of interaction" between the formal health system on one hand and the community system on the other.

Pathfinder's Integrated Systems Strengthening Model

Pathfinder's Integrated Systems Strengthening Model

Pathfinder believes that to provide long term solutions, we must connect people to systems, and systems to people. In keeping with Pathfinder's half century history of working with communities and the expertise this has built, Pathfinder has developed a model of systems strengthening that focuses on six sectors within the zone of health and community systems' interaction:

  1. Fostering empowerment and self-reliance within community and health systems
  2. Strengthening governance and leadership of civil society organizations and community leaders
  3. Developing supportive policy and political environments
  4. Improving service delivery of providers and health systems
  5. Ensuring strong evidence-based decision-making
  6. Expanding human and financial resources for health care

Learn more about our Integrated Systems Strengthening Model.

The key to success with this model is strong partnerships. Pathfinder has a long history of partnering with a range of groups—from local implementing organizations to Ministries of Health—to develop the underlying systems needed to effectively deliver sexual and reproductive health services. Our strong partnerships within both communities and the health system ensure that improvements are both effective within a local context, and sustainable. Learn more about our partners.

Measuring Our Success

As we forge improved systems, Pathfinder believes that high quality data lead to better programs, better accountability to donors, and a better understanding of "what works." Thus, setting goals, indicators, and then measuring outcomes is core to all that we do. Pathfinder programs collect data that are valid, reliable, and appropriate for their intended use. Read more about our evaluation strategy.

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