CARE and our partners help build strong community-centered health systems that improve access to quality care for everyone.
A strong health system is vital for good health. Yet in many countries, clinics lack basic supplies; facilities are understaffed, and communities struggle to access specialized treatment. In 2023, 3 billion people were served by health care facilities lacking sanitation services.
These gaps leave millions without essential services such as routine checkups, vaccinations, skilled birth care, and treatment for common illnesses.
Women and girls often face the greatest barriers. Harmful social norms, limited decision-making power, and financial constraints prevent many from seeking care.
For example, some cultures require women to ask for a male relative’s permission to seek care. This prevents many from accessing key health services, such as antenatal care or contraception. In settings impacted by humanitarian crises, these challenges grow even more dire.
Improving health outcomes requires more than medical treatment. It depends on systems that are fair, well-staffed, properly resourced, and tailored to the needs of the communities they serve. Especially women and girls.
How CARE strengthens health systems
CARE works with governments, frontline community health workers (FCHWs), local organizations, and communities to build health systems that are effective, people-centered, and accountable.
We focus on:
Supporting frontline community health workers
CARE and our partners train FCHWS to build skills and confidence and supply them with the tools they need to serve their communities.
Improving quality of care
We provide clinical training, mentoring, and regular supervision, supported by digital tools and data systems that help facilitate performance and improve service quality.
Strengthening community leadership and accountability
CARE supports community health committees and local groups to monitor services, engage with leaders, and advocate for improvements. These collective efforts ensure communities can shape the health services they rely on.
Working with governments to improve systems
We partner with national and local governments to strengthen policies, improve funding, and expand access to essential health services.
Key Approaches
Our key approaches to strengthening health systems include:
- Social Analysis and Action (SAA): A participatory approach that brings communities and health providers together to examine and challenge the harmful social norms and power dynamics that limit access to care.
- The Community Score Card (CSC): A citizen-driven accountability tool that helps communities and health facilities identify challenges, co-create solutions, and track improvements in quality of care.
Strengthening health systems in practice
Syria’s 13-year civil war led to a sharp rise in early marriages and adolescent pregnancies. This increase exposed a serious lack of health information and support for young mothers.
CARE and our partners worked with communities across the country to implement the Adolescent Mothers Against All Odds (AMAL) Initiative. AMAL supports pregnant adolescents and first-time mothers living in crisis-affected areas, while also helping communities examine power dynamics and social norms — the unwritten rules that shape how people act and treat one another.
Through the program, dialogue groups brought together influential community members, including religious leaders, teachers, and health workers, alongside families of young girls. These conversations helped challenge harmful norms and reduce bias around adolescents’ access to reproductive health services.
One key outcome was increased awareness of the harmful impacts of child marriage, as well as the importance of keeping girls in school.
