There is an increasing recognition that a holistic health systems approach is necessary to address public health challenges. A global cross-section of health system assessment (HSA) findings and experiences, including HSAs conducted in Uganda, Ethiopia, Guyana, the Caribbean and the Ukraine will be shared in the Panel. These findings will illustrate how integrating public health impacts health systems performance, including equity, efficiency, access, sustainability and quality. 1. Introduction: In order to assist countries in meeting the challenge of understanding and strengthening their health systems, USAID’s PHRplus (2001-2006) and HS20/20 (2006-2012) projects developed the HSA Manual published in 2007 and being updated regularly. The HSA Manual has since been used to assess health systems and guide policy-makers and program planners in more than 20 countries world-wide. HSA findings have contributed to National Strategic Plans, PEPFAR Partnership Frameworks, Policy changes, and numerous other health system strengthening activities. 2. Uganda: The HSA was conducted in 2011 by Makerere University and HS 20/20. Uganda has strong policies that need to be implemented to improve the health system. Improving service quality is a priority - facility-based quality improvement initiatives exist but need to be institutionalized uniformly. Many health worker positions are vacant, particularly in hard-to-reach areas with implications for access and equity – innovative approaches to provide incentives and contracting out to private sector are recommendations to address this. It is recommended that the MOH develop a roadmap for integrating HIV into public health service. 3. Ethiopia: Health system in Ethiopia is marked by a strong government leadership in shaping the areas of focus and engaging stakeholders. The results also showed that Health Extension Program is a commendable approach to improve coverage and uptake of preventive services. Reforms related to health care financing, facility governance, decentralized planning and HMIS are showing encouraging results in improving quality of health care, accountability in managing public funds and use of evidence for prioritizing health interventions. Areas for further improvement include involvement of the private sector, strengthening pharmaceutical logistics system, retention of HRH, improving fee waiver systems, and promoting community based health insurance. 4. Guyana: The HSA in Guyana piloted a stronger stakeholder engagement methodology which resulted in cross-cutting recommendations prioritized by local stakeholders as follows: (1) Improve coordination among different stakeholders and within the MOH; (2)Strengthen data availability and quality; (3) Create synergies between health system components and programs; (4) Decentralization of authority and services and (5) Expand MOH planning efforts to include a wider range of health system 5. Caribbean: HSAs have been conducted through-out the Caribbean, with an emphasis on HIV as defined by the USAID client there. Findings from Antigua and Barbados suggested four key areas for strengthening the health system and sustaining the HIV response: (1) Investing in financial analysis (costing) to inform strategic planning; (2) Prioritizing updates and passage of key legislation and gazetting of regulations to enforce enacted laws; (3) Improving access, efficiency, and quality at all levels of care and (4) Pursuing opportunities to engage the private sector as a partner. 6. Ukraine: The HSA found high-level government support for comprehensive health system reform, including a solid health reform strategy and an implementation plan. The assessment team identified four cross-cutting constraints: (1)Overall leadership and governance of the health system requires strengthening; (2) The structure of service delivery, including human resources, does not match the health needs of the population; (3) Health financing systems and budgeting norms adversely impact most aspects of the health system; and (4) While quality of care is improving in some priority areas, overall the content and nature of clinical practice in Ukraine requires further standardization and modernization.