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The Importance of Health Systems & Health Equity
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The term “health system” encompasses the personnel, institutions, commodities, information, financing and governance strategies that support the delivery of prevention and treatment services. The main objectives of a health system are to respond to people’s needs and expectations by providing services in a fair and equitable manner.1
The World Health Organization defines a health system as “all the activities whose primary purpose is to promote, restore, or maintain health.”2, 3 The World Bank defines health systems more broadly to include factors interrelated to health, such as poverty, education, infrastructure and the broader social and political environment.4
Well-functioning health systems are pivotal to achieving the Millennium Development Goals (MDGs) by 2015.5 The World Health Organization (WHO) has identified six components needed to establish, sustain and strengthen a health system, while allowing it to provide needed services, universal access to those services, and universal coverage of health care benefits.1
Developing countries, however, face many challenges to building robust, reliable health systems.2 These challenges include insufficient financing, lack of inter-agency coordination, poorly-functioning information systems, health worker shortages and supply interruptions.
- The health-care worker shortage limits the ability of many countries to meet the MDGs. The shortage weakens existing health-care delivery systems and inhibits expansion of services.5 For example, in 15 countries in sub-Saharan Africa there are five or fewer physicians per 100,000 people.6
- Both public and private sectors have a role to play in addressing the complex and unique challenges faced by developing countries to develop and maintain effective health systems issues. In many countries, less than half of the population has access to public health services.7
- Health systems strengthening aims to improve health by responding to people’s needs and expectations, and by providing services in a fair and equitable manner. Interventions include improving leadership and governance, ensuring a steady supply of medical products and creating more effective and efficient delivery systems.1
- Health systems research identifies challenges in providing care and delivering interventions at all levels of health systems and provides innovative solutions to improve the delivery of care. Confronting these challenges in settings where health infrastructure is crumbling on multiple fronts requires targeted research on health systems and health policy.8
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| 1 |
World Health Organization. 2000 World health report 2000: health systems: improving performance. Geneva: WHO. Available from: www.who.int/whr/2000/en/index.html |
| 2 |
WHO. 2008. Maximizing positive synergies between health systems and global health initiatives. Geneva. Available from: www.who.int/healthsystems/GHIsynergies/en/index.html |
| 3 |
Freedman LP, Waldman RJ, de Pinho H, Wirth ME, Chowdhury AMR, Rosenfield A. 2005. Who's got the power? Transforming health systems for women and children. UN Millennium Project Task Force on Child Health and Maternal Health 2005. Geneva: UNDP. |
| 4 |
World Bank. 2007. What is a health system? The World Bank Strategy for HNP Results. Available from: www.worldbank.org/ |
| 5 |
United Nations. UN Millennium Development Goals. (accessed April 26, 2009), Available from: www.un.org/millenniumgoals/ |
| 6 |
World Health Organization. 2006. World health report 2006: working together for health. Geneva: WHO. Available from: www.who.int/whr/2006/en/ |
| 7 |
Human Development Network. 2003. Private participation in health services. Washington, DC: The World Bank. |
| 8 |
Advancing evidence-based policy: bridging the boundaries between global health researchers and policy-makers. Global Health Conference, June 1, 2005, Washington, DC. Available from: www.globalhealth.org |
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