Health Systems and Workforce Strengthening Unit
Enhancing the capacities of health workers and systems
The Health Systems and Workforce Strengthening Unit (HSWS) at LSTM enhances health systems and develop the health workforce to deliver equitable, high-quality care, especially in fragile and shock-prone settings across the majority world.
Health systems are highly complex networks of people, institutions, and resources. In an ideal world, they are supported by strong policies, reliable medical supplies, and comprehensive systems to provide quality health care for all. A well-trained, supported, and motivated health workforce is at the heart of a resilient and sustainable health system.
However, health systems face constant local and global challenges—from conflict, climate crisis and disease outbreaks, to weak governance and workforce shortages. Through collaboration and learning, we at HSWS strengthen health systems and help their people deliver equitable, high-quality health care for all.
Our research focus and approaches
Supporting the health workforce
Health workers are an essential part of any health system. We focus on how to capacitate facility and community health workers in resource-poor and shock-prone settings to use their skills, data, and decision-making power effectively. We support evidence-informed practice, strengthen workforce resilience, and help managers develop strategies to retain staff in underserved areas. We apply a gender and intersectional lens to understand diverse experiences, examine disparities, and promote equity across the health workforce.
Health system strengthening
Our team works in settings where already weak health systems are subject to repeated and significant challenges, including political unrest, conflict, economic and social crises, and climate change. A resilient health system, which can function in such environments, is essential for sustainable improvements to health outcomes. We collaborate with stakeholders at every level—from the community to national agencies, non-state actors and global bodies—to co-develop policies and practices that foster responsive, resilient, inclusive and equitable health systems.
Our impact
Generating evidence
We co-produce and apply evidence to drive real-world impact. Working closely with stakeholders, we identify challenges and co-create practical, locally relevant solutions. Working with partners in Lebanon and Nepal, we used participatory action research to strengthen district decision-makers’ ability to generate, interpret, and act on evidence. This led to locally prioritised action plans that are improving performance and service delivery. We also share our findings globally, contributing to the wider evidence base on health systems and policy research.
Strengthening capacity and systems
Supporting health workers and managers to make better use of the resources and decision-making power they have, especially in decentralised systems, is a major part of our work. In Ghana, Malawi, and Uganda, our PERFORM2Scale study strengthened district health managers’ human resource management and health systems strategies to improve their districts’ performances.
We successfully integrated this approach into national policies, including Uganda’s National Quality Improvement Framework and Malawi’s Integrated Supportive Supervision tool. This strategy allows for scaling impact and ensures sustainability. The study also created valuable learning opportunities for early career researchers, who gained hands-on experience with support from senior mentors.
Driving change in policy and practice
Our interventions have impacted on policy and practice and hence on people’s lives. In Ghana, we partnered with national and local teams to improve health worker retention in the country’s most deprived districts in a study which has been well-received at the national level.
Globally, we co-authored a brief with the World Health Organization and the European Observatory highlighting how intersectoral governance can educate, employ, and retain a sustainable health and care workforce. This has influenced global debates on how to address health and care workforce challenges.
