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Today and every day,
the lives of vast numbers of people lie in the hands of health systems. From
the safe delivery of a healthy baby to the care with dignity of the frail
elderly, health systems have a vital and continuing responsibility to people
throughout the lifespan. They are crucial to the healthy development of
individuals, families and societies everywhere. Health systems of some sort
have existed for as long as people have tried to protect their health and
treat diseases. Traditional practices have existed for thousands of years and
often coexist today with modern medicine. Presently, health systems worldwide
are having to cope with a changing environment: epidemiologically, in terms
of changing age structures, the impact of pandemics, and the emergence of new
threats, politically in terms of changing perceptions about the role of the
state and its relation with the private sector and civil society; technically
in terms of the growing awareness that health systems are failing to deliver
– that often they tend to be inequitable and regressive.
Health systems are
defined as comprising all the actors, institutions and resources that are
devoted to producing action where the primary aim is to improve,
maintain or restore health. This includes efforts to influence determinants
of health as well as more direct health –improving activities. A health
system is therefore more than the pyramid of publicly owned facilities that
deliver personal health services. It includes, for example, a mother caring
for a sick child at home; private providers; behaviour change programmes;
vector control campaigns; health insurance organizations amongst others.
(WHO’s Framework for Action, 2007)
Health systems are
vibrant, evolve over time and interact with the political, social, economic
environment. Its overall goals include improvement in health and reduction in
health inequalities, securing fairness of financial contribution and being
responsive to user’s needs. The intermediate goals include achieving greater
access to and coverage for effective health interventions, without
compromising efforts to ensure quality and safety. However, a health
system is not simply the sum of its separate parts but a set of dynamic
entities with interactions - the building blocks of governance, financing,
human resources, service delivery, health technology support and health
information support are critical to ensure that the health system meets its goals.
(World Health Report 2000; WHO’s Framework for Action, 2007). Health System
Strengthening (HSS) will ensure that the functions and building blocks for an
effective health system are linked and that sufficient capacity in the
organisation is available to pursue a broad and comprehensive dialogue around
health systems strengthening and performance.
Links
National
Rural Health Mission
Ministry of
Health & Family Welfare, India
WHO SEARO
WHO HQ
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Health
Systems Strengthening
Health Policy
Health Sector Reforms
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