Health systems in low-income countries Flashcards
A health system - Definition
All services and
functions related to
financing, organisation
and delivery of health
services.
- includes promotive, preventive, curative and rehabilitation activities
WHO Definition:
* A health system consists of all
organizations, people and actions whose
primary interest is to promote, restore or
maintain health.
Low income definition
less than 1095 USD per capita
The WHO Health Systems Framework - System building blocks
- Leadership/governance
- Healthcare financing
- Health workforce
- Medical products, technologies
- Information and research
- Service delivery
The WHO Health Systems Framework - System goals/outcomes
- improved health (level and equity)
- responsiveness
- financial risk protection
- improved efficiency
Overall goal/objective of health systems?
What purpose does a ”health system”
serve?
– It is essential to define GOALS (objectives) for
the system!!
Overall goal: BETTER HEALTH
The health system is the only sector in the
society that has ”Better Health” as its primary
goal
– This specific characteristic of the health
system must be kept in mind continuously
3 dimensions of universal health coverage
UHC has been defined by the WHO as ensuring that “all people
obtain the health services they need without suffering financial
hardship when paying for them.”
The three dimensions of UHC
(population coverage, package of services provided and level of
financial protection) are often represented through the UHC
cube
i.e.
- Who is covered
- Which services are covered
- How big is the reliance on direct costs (is there a reduction in cost sharing and fees)
A well-performing health workforce?
A well-performing health workforce is one
which works in ways that are responsive,
fair and efficient to achieve the best health
outcomes possible, given available
resources and circumstances. I.e. There
are sufficient numbers and mix of staff,
fairly distributed; they are competent,
responsive and productive.
What are considered as ‘Good health services’?
Good health services are those which
deliver effective, safe, quality personal and
non-personal health interventions to those
who need them, when and where needed,
with minimum waste of resources
WHO: Health services should be:
- Of good quality
- Affordable
- Accessible
- Equitable
- Responsive
- Sustainable
A well functioning health information system?
A well-functioning health information
system is one that ensures the production,
analysis, dissemination and use of reliable
and timely information on health
determinants, health systems performance
and health status.
How does a well-functioning health system perform when it comes to access to medicine?
A well-functioning health system ensures
equitable access to essential medical
products , vaccines and technologies of
assured quality, safety, efficacy and cost-effectiveness, and their scientifically sound
and cost-effective use
What can be considered as ‘good health financing’?
A good health financing system raises
adequate funds for health, in ways that
ensure people can use needed services,
and are protected from financial
catastrophe or impoverishment associated
with having to pay for them.
Leadership and governance?
Leadership and governance involves
ensuring strategic policy frameworks exist
and are combined with effective oversight,
coalitionbuilding, the provision of
appropriate regulations and incentives,
attention to system-design, and
accountability.
What characterizes health systems in low income countries?
- low health expenditure per capita
- low doctors/1000 persons ratio
- high proportion of ‘private health spending’
Note: Weakness of the private health sector in some poor countries can be attributable to a lack of purchasing power for private health services, however, overall THE POORER THE COUNTRY THE LARGER THE PRIVATE SHARE OF HEALTH SPENDING (because the country is not able to sufficiently supply public health services)
Access vs coverage
- ‘access’ may be defined by travel distance, living distance etc (more passive) (e.g. living within 5km of a vaccination clinic)
- ‘coverage’ refers to actual utilisation (more active; how many people with access actually use the service) (e.g. vaccination coverage of 70%)
