Health systems
Lecture no 02


Health system
•A health system consists of all organizations, people and actions whose primary intent is to
promote, restore or maintain health.
•efforts to influence determinants of health
•direct health-improving activities
•More than the pyramid of publicly owned facilities that deliver personal health services.
•It includes individual help within family; private providers; behaviour change programmes;
vector-control campaigns; health insurance organizations; occupational health and safety
legislation.




Health system as organised effort
•Relatively new concept
•Germany – late 19th century
•Other states first half of the 20th century

Health system as a tool to achieve fundamental human right
•Art. 22: Everyone, as a member of society, has the right to social security and is entitled to
realization, through national effort and international co-operation and in accordance with the
organization and resources of each State, of the economic, social and cultural rights indispensable
for his dignity and the free development of his personality.
•Art. 25: Everyone has the right to a standard of living adequate for the health and well-being of
himself and of his family, including food, clothing, housing and medical care and necessary social
services

Service delivery
•Primary care
•Essential helath care/General health care
•Based on regular in-person meetings and consultations
•Secondary care
•Acute care – emergencies and short term hospitalisations
•Tertiary care
•Advanced care
•Highly specialized
•*Community Care
•
•Service financing
•public spending on interventions that are both cost-effective and have public good characteristics
•boost financing through charging users for services

Service delivery



What do we need to watch for efficient service delivery?



Health workforce



INFORMATION
•Information on health sector
•health determinants;
•health systems performance;
•health status of population
•Information on society
•Population expectations
•Population values

MEDICAL PRODUCTS, VACCINES AND TECHNOLOGIES
•quality,
•safety,
•efficacy and cost-effectiveness,
•scientifically sound and cost-effective use
•

SUSTAINABLE FINANCING AND SOCIAL PROTECTION
•Reducing need of high out-of-pocket payments
•transparency and accountability in health financing systems
•information on the health financing system and its policy use

6 LEADERSHIP AND GOVERNANCE
•Policy guidance
•sector strategies and also specific technical policies;
•Priority setting – strategic planning – operational planning
•Intelligence and oversight
•Processing information
•Collaboration and coalition building
•Across sectors in government and with actors outside
•government, including civil society
•Regulation
•Designing regulations and incentives
•System design
•reducing duplication and fragmentation
•Accountability
•Transparency of decision making processes