Health Systems Strengthening · WASH–IPC Integration · Laboratory Systems · Global Health Security · Policy Influence
Doris Bota, MSc, MA, BSc
Founder, The Integrated Health Systems Transformation Framework™
I work with governments, UN agencies, donors, and global health partners to integrate Infection Prevention and Control, WASH in health care facilities, laboratory systems and biosafety, and health security into government-led health systems. This means moving beyond fragmented projects toward stronger institutions, quality of care, public health and sustainable country ownership.
- Health Systems Strengthening
- WASH–IPC Integration
- Laboratory Systems
- Global Health Security
- Policy Influence
The problem
Most health systems are not short of plans. They are short of the arrangements that let a plan survive a funding cycle.
Infection prevention, WASH in health facilities, and laboratory diagnostics are usually financed as projects, delivered by partners, and measured against activity. They perform while the money lasts.
What decides whether they last is something else: whether the function has an owner inside government, a budget line, a standard, and a reporting cycle that continues after the project closes. That is the work.
The methodology
The Integrated Health Systems Transformation Framework™
The Integrated Health Systems Transformation Framework (IHSTF) is an integrated governance and implementation framework that brings WASH in health care, infection prevention and control, laboratory systems, and health security into one governed approach, connecting service delivery with institutional strengthening, multisectoral leadership, policy influence, and sustainable systems change.
From policy to practice. From projects to institutions.
Strategic focus
WASH–IPC and laboratory systems integration for quality care, patient and health worker safety
Leveraging WASH, infection prevention and laboratory systems to advance respectful maternity care, newborn safety, specimen referral and surveillance, outbreak preparedness, and the safety of patients and health workers — while improving quality of care and building resilient, integrated health services.
Transformation outcome
Health systems strengthening through governance and institutionalisation
Embedding health priorities into governance structures, policies, institutions, financing mechanisms, and accountability systems that endure beyond projects and funding cycles.
Strategic enabler
Multi-sectoral leadership and policy influence
Turning evidence, implementation learning, and stakeholder partnerships into policy decisions, investment cases, governance reforms, and systems change.
Knowledge management and MEAL — monitoring, evaluation, accountability and learning — run through every pillar, tracking quality, capturing learning, and generating evidence for adaptation and scale.
The instrument
The WASH and IPC Health Systems Wheel™
The IPC/WASH Health Systems Wheel helps embed IPC and WASH health priorities into governance structures, policies, institutions, financing mechanisms and accountability systems that endure beyond projects and funding cycles.
Eight domains that decide whether infection prevention and WASH are a function of the health system or a project running alongside it. Governance and financing, quality and data, people and preparedness — turning together or not at all.
- 01Policy & governance
- 02Financing & resources
- 03Quality improvement
- 04Training & capacity building
- 05Monitoring, surveillance & data
- 06Behaviour change
- 07Emergency preparedness
- 08Partnerships & knowledge management
Areas of practice
Where the work happens
Four strands that are usually managed separately and experienced by patients as one thing: to improve quality of care, patient safety and health reselience.
Health systems strategy, governance and leadership
Translating evidence and implementation learning into policies, financing approaches, institutional arrangements, and coordinated action across ministries, donors, and partners.
WASH–IPC integration, quality and safety
Closing operational gaps between WASH services and infection prevention performance to strengthen patient and health worker safety, quality of care, and outbreak readiness.
Laboratory systems and biosafety
Strengthening diagnostic networks, point-of-care testing, specimen referral, surveillance linkages, quality management, biosafety, and biosecurity across levels of care.
Multi-sectoral leadership and policy influence
Aligning ministries, donors, and implementing partners around one shared technical and policy agenda, and turning that alignment into policy decisions, investment cases, and systems change.
Proven impact
A record of account
Eighteen years of technical leadership, counted in the things that were actually built.
- 18+
Years
Strategic and technical leadership across global health systems.
- 277M+
USD
Maternal and newborn health programme for which Doris led the WASH and IPC technical portfolio across multiple countries.
- 22
Countries
Supported through UNICEF's Hand Hygiene for All initiative.
- 32
Networks
Country-level faith-based health networks coordinated and strengthened under the USAID MCGL project.
Systems transformation in practice
Two engagements, set out in full.
National biosafety governance and laboratory systems strengthening in Kenya, and WASH–IPC integration within USAID MOMENTUM Country and Global Leadership. Context, challenge, approach, results — and what each one taught about making a technical function last.
“She is one of the most dependable, knowledgeable and forward-thinking IPC specialists I have worked with.”
Dr. Collins Jaguga
Management Sciences for Health · USAID MTaPS, Kenya
The IPC/WASH Health Systems Fragmentation Diagnostics
Where is fragmentation holding your system back?
The IPC/WASH Health Systems Fragmentation Diagnostic™ is an assessment instrument developed as a companion to the IHSTF. It evaluates ten defined dimensions of WASH, IPC, and health system integration and produces a personalised gap analysis with prioritised recommendations, completed by a user in five to ten minutes.
Score ten domains of health-system integration on a four-point maturity scale and receive a gap analysis with your three priority domains and a practical 90-day plan.
· Five to ten minutes · Instant report, emailed to you
- 1Highly fragmented
- 2Partly coordinated
- 3Mostly integrated
- 4Fully integrated
The maturity scale
Contact and scoping
Start a scoping conversation.
Registered on UNGM and available for roster, TOR, and RFP processes with governments, UN agencies, development partners, and implementing organisations.
For multidisciplinary or larger-scale assignments, Doris works with a trusted network of specialist associates, bringing together complementary expertise according to the needs of each engagement.