WHICH

1

• WHICH
• Health Service Delivery
• For 5 per capita per year?

2
What is a Health System?

• A health system consists of
• all organizations, people and actions
• whose primary intent is
• to promote, restore or maintain health

3
Health System Strengthening

• Building Blocks
• Service Delivery
• Financing
• Health Work Force
• Information
• Medical Products Commodities
• Leadership Governance

4
What is Service Delivery?

• Good health services are those which deliver
• effective, safe, good quality personal and
  non-personal health interventions
• to those that need them, when needed
• with minimum waste of resources.

5
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.

6
Fragility and Health Sytems

7
Evidence

• Increased Resource Improved Outcomes
• Therefore
• 5 pc/year better than 2 pc/year
• BUT
• It is only part of the HS expenditures
• Is it adequate funding?

8
Evidence

• Contracting out and P4P are appealing and can be
  an effective option for service delivery in
  various settings
• BUT
• They only address some of the HSS issues and do
  not address fragility

9
Evidence

• There is no HSS without improved governance and
  capacity
• There is no HSS without adequate HRH

10
Leadership and governance

• Overseeing and guiding the whole health system,
  private as well as public, in order to protect
  the public interest
• It requires both political and technical action
• It involves reconciling competing demands for
  limited resources, in changing circumstances
• It requires long term strategic vision