Health systems, goals of health system, Leadership and Governance Human Resource for Health Health Financing Medicines and Technologies Service Delivery, and Health Information System

1. Shiva Ram Khatiwoda
Health System
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2. Health System
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3. Health System
• System is a grouping of different component parts that
operate together as a whole.
• A system is a set of interacting and/or interdependent
component parts, forming a complex whole.
• Health system is intended to deliver health services.
• It involves of planning, determining priorities, mobilizing
and allocating resources, translating policies into services,
evaluation and health education.
• It consists of concepts (e.g., health and disease); ideas
(e.g., equity, coverage, effectiveness, efficiency, impact);
objects (e.g., hospitals, health centers, health programs)
and persons (providers and consumers).
• The aim of health system is health development.
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4. Health System …
• The combination of resources, organization, financing
and management that culminate in the delivery of health
services to the population. Roemer (1991)
• All activities (organization, people and action) whose
primary purpose is to promote, restore and maintain
health. (WHO 2000)
• A health system is therefore more than the pyramid of
publicly owned facilities that deliver personal health
services. This also includes efforts to influence
determinants of health as well as more direct health-
improving activities.
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5. Goal of health system
• Primary goal - Improving health of people:
– By respecting people’s dignity, autonomy and
confidentiality – through - responsive, financially
fair, and efficient mechanisms
– By assuring - equity, access, coverage, quality,
safety

6. Goals of Health System
• Three basic goals of Healthcare system:
– I. Keeping people healthy
– II. Treating the sick
– III. Protecting families against financial ruin from
medical bills.

7. Objectives of health system
• Improving the health of the population they
serve;
• Responding to people’s expectations;
• Providing financial protection against the costs
of ill-health.

8. Function of health system
• providing services
• generating the human and physical resources
that make service delivery possible
• raising and pooling the resources used to pay
for health care
• stewardship – setting and enforcing the rules
of the game and providing strategic direction
for all the different actors involved.

9. Health system function and outcome
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10. Concept of Health System Development
• Health systems development concerns the institutional set-up
of the health sector and the way in which the health system’s
functions are organized and performed.
• It includes development and maintenance of all components
of health systems i.e. provision of health services, health work
force, information system, health financing, medical products
and technology and stewardship
• Provision of health services involves the design and
implementation of health care delivery models, as well as
specific ways in which services should be organized and
managed to deliver community and clinical interventions.
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11. Principles of Health System
Development
1. Sustainability: The system must be long-lasting to
provide high quality service and encourage innovation
and continuous improvement.
2. Quality: A quality health system is one that provides
the right care at the right time in the right way by the
right person. Quality should be maintained in all
personal and community health services.
3. Comprehensive: A health system should include all
promotive, preventive, curative and rehabilitative
health services to improve the overall health status of
the populations.
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12. Principles of Health System
Development …
4. Participatory: It is necessary to involvement of
all stakeholders in planning, implementation
and evaluation of health services.
5. Safety: Health systems should provide better
quality health services without any adverse
consequences to the patients/clients, health
care providers as well as whole community.
6. Equity: “fairness while providing the health
services and resources” or “justice according to
natural law or right; especially free from bias or
favoritism”.
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13. Principles of Health System
Development …
7. Access: All community people should access in reaching
health services or health facilities irrespective to location,
time and social and cultural factors.
8. Choice: People should have right to select or reject any
course of intervention while providing health services
based on their knowledge, preference and socio-cultural
ethics.
9. Affordable: A sustainable health system should provide
basic health services on an affordable cost to all people
with long-term plan.
10. Efficiency: health system should yield/generate maximum
output with scarce resources.
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14. Building Blocks of Health System
According to WHO- six building blocks of HS are-
1. Leadership and Governance
2. Human Resource for Health
3. Health Financing
4. Medicines and Technologies
5. Service Delivery, and
6. Health Information System
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Health
System
Leadership
and
Governance
Health
Information
System
Service
Delivery
Health
Financing
Human
Resources for
Health
Essential Medical
Products and
Technologies

15. The “Control Knobs” of a health system
(Harvard and WBI)
1. Financing
2. Payment
3. Organization
4. Regulation
5. Persuasion and Behaviour Change
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16. Thank You
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