Global Health Systems Research
Global Health Infrastructure Index
A framework for directing health infrastructure investment to where it is most likely to improve access to care.
The gap this framework closes
The people making funding decisions rarely talk to the people working inside the systems being funded.
Most global health investment is directed from a distance. Allocators have access to indices, rankings, and aggregate outcome data — but rarely to the practitioners, ministry officials, and operators who know what is actually missing, what was tried and failed, and where the next dollar would do the most good. Meanwhile, the people inside these systems often have no framework to articulate what they need, to whom, and in what order. Capital ends up in the wrong places. Decisions get made with partial information. And communities go underserved.

This index is built to close that gap. It maps countries on three dimensions that shape whether infrastructure investment will actually work — the capital reaching the health system, the policy and incentive environment surrounding it, and the sophistication tier at which the system operates. The classifications are published openly, refined by field contributions from practitioners, and designed to support better conversations between the people deciding where capital goes and the people it is meant to reach.
The moment this started
In late 2025, I traveled to Iraq with a group actively deploying capital into healthcare. At one of the hospitals we support, we asked the administration a direct question: "What else could we fund that would meaningfully improve your ability to deliver care?" We were there to write a check. We encouraged them to think broadly — equipment, facilities, workflow, anything. We never received a clear answer. This was not a hospital that had everything it needed. It was a hospital that, when asked directly, could not clearly articulate what it would prioritize next. No framework for evaluating options. No visibility into what peer institutions had tried. No sense of which investments would actually move the needle.
The gap was not just resources. It was decision-making infrastructure.
4.5B
people lack access to essential health services worldwide
WHO
$371B
annual funding gap for health in low-income countries
WHO
1 : 10K
doctor-to-patient ratio in sub-Saharan Africa vs. 35 per 10K in high-income countries
WHO
3×
economic return for every $1 invested in health infrastructure in LMICs
World Bank
Where to start, depending on why you're here:
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I have field experience to share
You've worked inside a health system — as a clinician, NGO operator, ministry official, supplier, or researcher — and have seen what works and what doesn't. Your observations directly shape how countries are classified and where investment gets directed.
Share what you've seen
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I'm deploying resources and need a framework
You're allocating capital, designing a program, or evaluating where to direct health investment. Start with the map to see how countries are classified, read the methodology to understand the reasoning, and find the investment thesis that fits the context.
Explore the framework
Methodology
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How classifications are assigned
The full methodology behind the framework — what the three axes measure, what data sources inform classifications, how field research promotes inferred classifications to research-verified, and what this framework can't tell you.
Read the methodology
Map color: policy alignment
Aligned
Mixed
Broken
Not classified
Map border: system sophistication
Foundational
Intermediate
Advanced
Double-click any country for full 3-axis detail
Health Infrastructure Map
Hover to see classification · Double-click any country for details or to contribute
All classifications are inferred baselines
Investment Matrix
Capital allocation × policy alignment · border thickness shows sophistication tier
System sophistication (border):
Foundational
Intermediate
Advanced
* Representative countries shown per cell. marks countries with direct research insight (Iraq, Lebanon, Syria, Sudan).
Research and case studies
Field research that grounds the framework in real-world context
Case Study · Iraq
Medium Capital Yellow Policy Advanced system
The Iraq imaging equipment market
An imaging equipment supplier reveals why financing — not demand or technology — is the binding constraint in Iraqi health infrastructure.
Read the case study →
Case Study · Conflict settings
Low Capital Red Policy
Access is not an infrastructure problem
A humanitarian pediatrician's reflections on why building hospitals in broken systems can fall short of its promise — and the post-conflict prosthetics gap as a coordination opportunity.
Read the case study →
Case Study · Cross-country
Lebanon · Pakistan · Cambodia
Where equipment and system meet
A cardiac electrophysiologist on why equipment and the surrounding system have to work in unison — and how Pakistan's Shaukat Khanum hospital proves that unity can be built deliberately even in tough environments.
Read the case study →
 All case studies →

What You've Seen Could Direct Where Capital Goes Next

Global health investment routinely misses the mark because the people making funding decisions rarely have direct access to the people working inside the systems being funded. This framework exists to close that gap. If you've seen a hospital that couldn't use the equipment it was given, a supply chain that broke in a specific link, or a workforce gap no donor saw coming — tell us. That's the intelligence investment depends on.

Submissions are reviewed by our research team. Contact info is only used to follow up with your permission.
🤖 AI Research Interview
I'm an AI assistant helping to gather field intelligence for this research. I'd like to ask a few follow-up questions to make sure we capture the most useful details — especially anything specific to the countries and region you've tagged. You can skip anytime.
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Thank you for contributing
Your experience has been submitted to our research team. We'll review it and may reach out if you've shared contact details. Your insights help improve health infrastructure investment decisions for communities that need it most.