Day 2: Health System

This is the continuation of the introduction.

Here, I'll b explaining more on the definitions before going into details bout the health system...

Before defining what health system, 1st what do we understand bout 'System'?

System is an organized collection of parts (or subsystems) that are highly integrated to accomplish an overall goal.

Here are some various examples of systems:

1. Biological systems (heart)
2. Mechanical systems (thermostat)
3. Human/Mechanical systems (riding a bicycle)
4. Ecological systems (predator/prey)
5. Social systems (groups, friendship)

Systems consists of 4 parts/subsystems:

1. Objects - the parts, elements or variables within the system
2. Attributes - the qualities or properties of the system and its objects
3. Internal relationships among its objects
4. Systems exist in an environment

Since we have an idea about the concept of system, now lets move on to health system. 

So,  what is Health System?

A health system consists of all the organizations, institutions, resources and people whose primary purpose is to improve health. 

In the World Health Report 2000, health systems are defined as comprising all the organizations, institutions and resources that are devoted to producing health actions. 

A health action is defined as any effort, whether in personal health care, public health services or through inter-sectoral initiatives, whose primary purpose is to improve health.

A good health system delivers quality services to all people, when and where they need them. 

The exact configuration of services varies from country to country, but in all cases requires:

• a robust mechanism;
• a well-trained and adequately paid workforce;
• reliable infromation on which to base decisions and policies;
• well maintained facilities and logistics to deliver quality medicines and technologies.

A well functioning health system responds in a balanced way to a population’s needs and expectations by:

• improving the health status of individuals, families and communities
• defending the population against what threatens its health
• protecting people against the financial consequences of ill-health
• providing equitable access to people-centred care
• making it possible for people to participate in decisions affecting their health and health system

According to WHO 2010, the key components of a well functioning health system are:




1.  Leadership and Governance

• Ensuring that health authorities take responsibility for steering the entire health sector; and for dealing with future challenges as well as with current problems.
• Defining, through transparent and inclusive processes, national health policies, strategy and plan that set a clear direction for the health sector.
• Effective regulation through a combination of guidelines, mandates, and incentives, backed up by legal measures and enforcement mechanisms.

2.  Health Information Systems

• Progress in meeting health challenges and social objectives; including but not limited to household surveys, civil registration systems and epidemiological surveillance
• Access to care and on the quality of services provided.

3.  Health Financing

• A system to raise sufficient funds for health fairly
• A system to pool financial resources across population groups to share financial risks
• A financing governance system supported by relevant legislation, financial audit and public expenditure reviews, and clear operational rules to ensure efficient use of funds

4.  Human Resources for Health

• Arrangements for achieving sufficient numbers of the right mix (numbers, diversity and competencies)
• Regulatory mechanisms to ensure system wide deployment and distribution in accordance with needs
• Mechanisms to ensure cooperation of all stakeholders ( such as health worker advisory groups, donor coordination groups, private sector, professional associations, communities, client/consumer groups)

5.  Essential Medical Products and Technologies

• A supply and distribution system to ensure universal access to essential medical products and health technologies through public and private channels, with focus on the poor and disadvantaged
• A national programme to promote rational prescribing
• A medical products regulatory system for marketing authorization and safety monitoring, supported by relevant legislation, enforcement mechanisms, an inspectorate and access to a medical products quality control laboratory

6.  Service Delivery

• Networks of close-to-client primary care, organized as health districts or local area networks with the back-up of specialized and hospital services, responsible for defined populations
• Standards, norms and guidance to ensure access and essential dimensions of quality: safety, effectiveness, integration, continuity, and people -centeredness
• Mechanisms to hold providers accountable for access and quality and to ensure consumer voice

REFERENCES:

1. Lecture 1: Introduction of Block 4.2 : Health System and Disaster Management (Prof. Laksono)
2. WHO: Key Components of a Well Functioning Health System
3. The World Health Report 2000
4. WHO: Health Systems