Building strong, inclusive, resilient, and sustainable health systems
We envision strong, inclusive, and resilient health systems that ensure coverage, access, and use of high quality sexual and reproductive health and rights services as a fully integrated core component of Primary Health Care.
Pathfinder support for health systems strengthening is firmly nested within an overarching strategy designed to ensure more locally led, rights-based, inclusive, and gender-responsive approaches.

As can be seen in the graphic at left (from recent work with USAID Transform in Ethiopia), Pathfinder systems support contributes to improving the quality of services while simultaneously ensuring bottom-up collaborative program learning and adaptation. This in turn leads to improved health seeking behavior and ultimately measurably improved system performance and a positive user experience.
Building Resilient Health Systems

Within the unprecedented global context of overlapping crises, including the COVID-19 pandemic, persevering epidemics, climate-induced natural disasters, conflict, forced migration, and economic stress, the importance of Primary Health Care and responsive and resilient health systems has never been greater.
As depicted in the graphic to at right, Pathfinder builds upon the foundation of six building blocks to include a strong focus on the individual and community at the center, recognizing their critical role as key actors in locally led, nationally owned primary health care systems.
Increasing Rights, Individual Agency, and Choice
Pathfinder focuses on promoting individual agency and rights in our programming, with an emphasis on contraceptive autonomy whereby all people have informed, full and free, voluntary choice in their reproductive decision-making. This work includes transforming social norms and instilling accountability mechanisms that affect women’s and young people’s decision making and planning processes, and advancing options that support self-awareness, self-testing, and self-care. Last, Pathfinder works to fulfill every person’s right to care including quality counseling tailored to patient needs, free of judgement and coercion.
Provision of Quality Essential Services
Pathfinder strengthens the capacity of providers to improve the quality and diversity of service delivery points. Pathfinder uses social and behavioral change strategies to motivate clients, improve client-provider interactions, and boost adherence to service protocols, as well as uses technology and digital means to advance sustainable solutions for women and communities. Pathfinder works to strengthen the health workforce across the spectrum of pre-service and in-service training, complemented by mentoring, supportive supervision, and professional certification with a focus on frontline health workers, especially women. Pathfinder also works to strengthen health markets, supporting the strategic engagement of the private sector to advance health outcomes in areas including family planning, maternal newborn and child health, malaria, HIV and AIDs, and tuberculosis.
Increasing Health System Readiness
Pathfinder supports crisis-affected communities and institutions to adapt and strengthen preparedness capacity as an integral component of both crisis and development programming. Our programs enhance the resilience of multiple sectors simultaneously, delivering programs that tackle the intersectional nature of shocks and stressors, as well as the ability of women and girls to navigate health-related stressors and shocks. Pathfinder works closely with governments and civil society to strengthen commodity security and supply chains across health systems.
Creating an Enabling Environment
Pathfinder advocates locally, nationally, and globally for robust donor funding and domestic resources as well as strong policies to improve access to and quality of sexual and reproductive health care for women and youth. Pathfinder works with governments to prioritize sexual and reproductive health and rights in both funding and practice as a critical part of Universal Health Coverage. This work includes building functional linkages between the public health system, the private sector, and communities to strengthen local health markets. Pathfinder facilitates locally led, inclusive, and nationally owned processes and outcomes.
Strengthening Health System Building Blocks
Pathfinder works to strengthen the underlying ‘building blocks’ of strong Primary Health Care systems.
- Health workforce: A highly skilled and motivated workforce is at the heart of an effective health system. Pathfinder works across the spectrum of pre-service and in-service training, complemented by mentoring, supportive supervision, and professional certification with a focus on frontline health workers, especially women.
- Leadership and governance: Pathfinder recognizes strong national leadership alongside pragmatic and structured governance and accountability mechanisms (including national, civil society, and private sector) are imperative for health system strengthening efforts to be effective. Pathfinder supports locally led, bottom-up planning and monitoring together with rigorous learning approaches, where community members, service providers, and managers can all be actively engaged at their respective levels of governance.
- Health information: An effective health management information system (HMIS) can improve SRHR information accessibility, reliability, transparency, and use for better accountability, learning, and governance across the health system. Pathfinder works to support collaboration, learning, and adaptation of existing information systems to explicitly respond to key decision-making moments.
- Commodity security: Pathfinder supports the improvement of commodity security and supply chain management at all levels of the health system. Pathfinder also supports the special needs of logistics management in fragile and crisis contexts.
- Health system financing: Sufficient and sustained funding is a prerequisite for an effective health system. Pathfinder works to build strong functional linkages between public health and private sector service delivery, which directly reduces financial pressure on the public health systems
- Health service delivery: Pathfinder supports integrating services to avoid missed opportunities and gain greater efficiency. Pathfinder advocates for self-care as an underutilized option of service delivery with tremendous potential for individual-initiated and rights-based self-awareness, testing, and management of a selection of SRH services. Pathfinder also works to ensure service delivery continues even in contexts of crisis and fragility by supporting efforts across cycles of preparedness, adaptation, and recovery.
Pathfinder’s Fiduciary Agency Model
Pathfinder partners with host governments and ministries of health in creating efficient, sustainable, and impactful health programs. We use a proven approach that transitions from Pathfinder serving as fiduciary agent for the government to a government’s autonomous management of donor funds and activities.

Countries using this approach
Featured Projects

OSRA (Family)
For nearly 40 years, Pathfinder has partnered with the Government of Egypt to advance reproductive health in the country. Pathfinder’s…

Integrated Family Planning Program
Pathfinder designed the Integrated Family Planning Program to meet women where they are. We implement three tailored packages of interventions—a…

Shukhi Jibon
In partnership with the Ministry of Health and Family Welfare, this project provides adaptive, needs-driven technical assistance and systems strengthening…

Pamoja
Pamoja—meaning “together” in Swahili—aims to reduce maternal deaths caused by unsafe abortion by supporting the Government of Tanzania to improve…

MOMENTUM Integrated Health Resilience
MOMENTUM Integrated Health Resilience (MIHR) improves equitable access to quality maternal, newborn, and child health; nutrition; voluntary family planning; and…

Naya Qadam
In Pakistan’s Punjab and Sindh provinces, Naya Qadam reaches thousands of young women ages 15 to 24 at a critical…

Frontier Health Markets (FHM) Engage
FHM Engage improves the functioning of local health markets in USAID priority countries and supports the strategic engagement of the…

Transform: Primary Health Care
Benefiting nearly 53 million people, the Transform: Primary Health Care project strengthens the management and performance of Ethiopia’s national health…
In Six Months, A Big Change
Expanded access to modern contraception through targeted advocacy in DRC What can an organization like Pathfinder achieve in six short…
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