Better health outcomes depend on better health systems
Globalization is putting the social cohesion of many countries under stress, and health systems are clearly not performing as well as they could and should. Few would disagree that health systems need to respond better – and faster – to the needs of people and the challenges of a changing world.
National health policies, strategies, and plans provide a framework in almost every country for dealing with the complex range of issues needed to improve health outcomes, including those related to the Millennium Development Goals and to other national priority health problems, such as noncommunicable diseases. Bringing different stakeholders together in the process of developing policies, strategies, and plans leads to a more balanced, coherent approach that is needed to make better use of resources for health and move towards long-term improvements.
Achieving health targets depends on equitable access to a health system that delivers high quality services. The exact configuration of services will depend on country context, but will in all cases require attention to certain basic "building blocks":
- adequate financing with pooling of risk;
- a well-trained and adequately remunerated workforce;
- information on which to base policy and management decisions;
- logistics that get medicines, vaccines and technologies to where they are needed;
- well-maintained facilities organized as part of a service delivery and referral network; and
- leadership that sets and enforces the rules of the game, provides clear direction and harnesses the energies of all stakeholders - including communities and other sectors.
What guides health system strengthening?
In the WHO constitution and through many World Health Assembly resolutions, WHO Member States have defined principles, values and goals considered fundamental to allow all people enjoyment of the highest attainable standard of health.
These were reaffirmed in the broad call for the renewal of Primary health care, and its four main policy directions, as set out in the World Health Report 2008: universal coverage, people-centred care, integrating health in all policies, and inclusive governance. The report responded to the appetite from policy makers in all regions for knowledge about how health systems can become more equitable and inclusive, at the same time reflecting a shift towards more comprehensive thinking about the performance of the health system as a whole.
The World Health Report 2010 focuses on the first goal – universal coverage – by responding to the need, expressed by rich and poor countries alike, for practical guidance on ways to finance health care. The report maps out what countries can do to modify their financing systems so they can move more quickly towards universal coverage – and sustain gains that have been achieved.