[EQ] Analysing Health SystemsTo Make Them Stronger

Analysing Health SystemsTo Make Them Stronger

van Olmen J, Criel B, Van Damme W, Marchal B, Van Belle S, Kegels G, et al.
Studies in Health Services Organisation & Policy; 2010

Available online PDF [102p.] at: http://bit.ly/b3KoQR

“…..The attention for Health Systems and Health Systems Strengthening has re-emerged in the frontlines of global debate since several years. This document aims to clarify the authors’ ideas and visions on HS development by presenting a framework for description and analysis. The book outlines a framework that can be used by anybody wishing to analyze and strengthen HSs and it elaborates a vision for discussion….”

“…….The conceptualisation of HSs at national level started in the eighties, with models that describe actors and processes. The broad definition of a HS as “all organizations, institutions and resources devoted to producing actions whose primary intent is to improve health” has become widely accepted, but the further elaboration into explanations and strategies has been subject to various interpretations (World Health Organisation 2000).

Frameworks for HSs serve different purposes, from describing or analysing existing situations to predictive and prescriptive models (Hsiao et al. 2009).
The difference between various frameworks is not always obvious and many contain elements of all these aims.
There are comprehensive frameworks for the national level, of which those of the World Health Organisation (WHO) are most dominant (World  Health Organisation 2000; World Health Organisation 2007; World Health Organisation 2009). A HS analysis can zoom in, resulting in frameworks for subsystems.

There are frameworks for specific ‘building blocks’ (e.g. a fund-flow framework), for the interaction between actors (e.g. a demand-supply framework) or between different components (e.g. frameworks for integration between programmes and health services). An important framework that is focused on the subsystem of primary health care, but that at the same time links very well with the overarching goals and other elements of the HS, is provided by the World Health Report 2008 (World Health Organisation 2008a). Lastly, HS can be looked at from different levels, which brings about frameworks for local health systems or individual health care delivery organisations. A more detailed description of existing frameworks over time is given in annex one………….”

 

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