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The African Region has witnessed significant improvements in population health outcomes over the past two decades. However, these gains still fall short of global and regional targets and are not uniform across or within countries. The Region is also faced with major demographic, economic, epidemiologic, and socio-cultural transitions as well as health security and environmental threats which place greater demands on health systems.

In response to these, and to guide Member States in strengthening their health systems towards achieving universal health coverage and the sustainable development goals, the WHO Regional O ce for Africa has developed a framework of actions which builds on various prior frameworks. It is rooted in an integrated approach to systems strengthening, a focus on communities and districts, and appropriate sequencing of actions for the best possible outcomes. The framework calls for investments in seven health systems input areas, and facilitates more pro-active results monitoring through four output areas and six outcomes that measure the impact on wellbeing for all.