In many low- and middle-income countries (LMIC), health systems strengthening (HSS) efforts have often involved partnerships between domestic institutions, international donors, and external providers of technical assistance. As donor funding declines, countries are seeking to build capacity for HSS independent of international support. This objective aligns well with the overall goal of the Accelerator program, which aims to connect locally driven health system innovation with global knowledge, improve the institutional architecture for evidence based and sustainable HSS, and accelerate countries’ journeys to self-reliant health systems.

The Accelerator has developed an institutional architecture framework to assess and build capacity for self-reliant, continuous HSS in LMICs. The framework will enable country leaders to self-assess strengths and weaknesses in their HSS capacity, deliberately plan for capacity building, and track progress toward self-reliance. In addition, it is hoped that external assistance providers will be able to better prioritize how to complement existing capabilities to implement activities and strategically invest in building additional capabilities. The result will be accelerated progress on key health systems challenges and a faster path to self-reliant HSS.

This document summarizes work to date on the Accelerator’s framework for the institutional architecture for HSS and options for future application of the framework.