6. Evidence already exists tiering practice
changes within primary care.
tier 1 : "full-service brokers" and will be delivered by a wide
variety of clinicians.
tier 2 : grapple with
tensions created by
patient demand and
bureaucratic systems
tier 3 : concerned with
community health and
social justice.
7.
8. Strengthening health systems
Building Blocks of the health system and link to health outcomes
Source: World Health Organization. Everybody’s Business:
Strengthening health systems to improve health outcomes—
WHO’s Framework for Action. Geneva: WHO, 2007, page 3.
9. Building blocks
– Health systems are highly context specific
– No single model for improved performance
– Key challenge: cost-effective and high-impact
interventions available
– But…they require a functioning health system to
have an effect at the population scale
– Question: how to get drugs, vaccines, and other
forms of prevention, care and treatment – on
time, reliably, in sufficient quantity and at
reasonable cost – to those in need?
– Need for learning from country’s experience on
integration of building blocks
10. Building blocks
– Integration of building blocks
Leadership/
stewardship
Human
Resources
Pharmaceuticals
Planning
and M&E
Health Care
Financing
Health
Services
11.
12.
13.
14.
15. The World Health Report 2008
The social values that drive PHC
and the corresponding sets of reforms
16. Three ways of moving towards universal
coverage
(WHR: 2008 & 2010)
24. Percent DALY 1999, 2004
and 2009 Male
24
Burden of Disease Thailand, 2009
25. Percent DALY 1999, 2004
and 2009 Female
25
Burden of Disease Thailand, 2009
26. Percent DALY 1999, 2004,
and 2009 Both
26
Burden of Disease Thailand, 2009
27. Integration of building blocks
CEO District Health System
Leadership/
stewardship
Human
Resources
Pharmaceuticals
Planning
and M&E
Health Care
Financing
Health
Services
