Health systems vary widely in performance, and countries with similar levels of income, education and health expenditure differ in their ability to attain key health goals. This paper proposes a framework to advance the understanding of health system performance. A first step is to define the boundaries of the health system, based on the concept of health action. Health action is defined as any set of activities whose primary intent is to improve or maintain health. Within these boundaries, the concept of performance is centred around three fundamental goals: improving health, enhancing responsiveness to the expectations of the population, and assuring fairness of financial contribution.
Local Resources can significantly contribute to national governments' and external donors' efforts to maintain and extend health programs. By identifying and using the full range of local resources, both monetary and non-monetary, health programs can help build partnerships among public, private and government sectors; involve individuals and groups in the community; and strengthen and expand health services.
National health systems need strengthening if they are to meet the growing challenge of chronic diseases in lowincome and middle-income countries. By application of an accepted health-systems framework to the evidence, we report that the factors that limit countries’ capacity to implement proven strategies for chronic diseases relate to the way in which health systems are designed and function. Substantial constraints are apparent across each of the six key health-systems components of health fi nancing, governance, health workforce, health information, medical products and technologies, and health-service delivery.
The typical business model for banking in the developed and developing world has been to encourage the unbanked (those at the bottom of the pyramid) to the bank. Since the deep penetration of mobile phones across the global north and south, mobile devices are now bringing the bank to the unbanked. Now with the click of a button you can transfer money (internationally and domestically), check account balances and financially plan smarter. The Health Service Delivery Model
Innovation happens. With all the new technologies and processes sprouting every day in Africa, it becomes more and more challenging to manage and keep track of innovation. This is also the case, unfortunately, at organizational levels.
Nous pouvons vous annoncer le lancement officiel de la communauté de pratique PBF. Cela s'est fait dans le cadre d'un atelier qui s'est déroulé à Bujumbura du 3 au 6 février (voir www.performancebasedfinancing.org). Dans les semaines qui suivent, nous allons mettre en ligne le travail des participants.
by Alexander S. Preker
At the dawn of history, people used home remedies and private healers when they were ill. By the second millennium B.C., the papyri, give fascinating evidence that Imhotep, archetypal physician, priest and court official in ancient Egypt, introduced a system of publicly provided health care with healers paid by the community. This early experiment in socialized medicine did not survive the test of time. The Code of Hammurabi (1792-1750 BC) laid down, inter alia, a system of direct fee-for-service payment based on the nature of services rendered and the ability of patients to pay. For the next three thousand years, involvement by the state in health care revolved mainly around enforcing the rules of compensation for personal injury and protection of the self-governing medical guild. Only during the 20th centry did the pendulum swing back to greater state involvement.
Do you think governments today can achieve public ends through private means? Join the debate.
The Bank’s HNP strategy emphasizes strengthening health systems in areas including financing, governance, insurance, logistics, provider-payment and incentive mechanisms, human resources, basic infrastructure and supplies (World Bank 2007). While strengthening health systems is integral to the attainment of the MDGs, some have argued that an exclusive focus on financing, human resource and supply chains tends to neglect reproductive health priorities (Standing 2002). Key elements for linking health sector reform efforts to desired health outcomes have been identified in the reproductive health literature (Ramachandran 2002).
February 26, 2008 -- Despite billions of dollars invested into health in Africa, the shortage of appropriate health workers particularly in rural areas in many countries is a major barrier to health service coverage for the poor.