Building Blocks of Health Systems

Health System

• A health system comprises all organizations, institutions, and resources devoted to producing health actions (WHO, 2000)
• It consists of all organizations, people, and actions whose primary intent is to promote, restore, or maintain health, regardless of whether health agents are public, governmental, non-governmental, or private (WHO, 2007)
• A health system includes three items: delivery of health services, activities to enable the delivery of health services, and stewardship activities aimed at influencing the health impact of relevant interventions in other sectors (Figueras and McKee, 2012)

Building Blocks of Health Systems

• The original objectives of the health system are to promote common understanding, address new challenges and set priorities, address questions of health system financiers, and strengthen WHO's role in health systems (WHO, 2007)
• Health systems are considered an intermediate social determinant of health (WHO, 2008)

Service Delivery

• Good health services deliver effective, safe, quality personal and non-personal health interventions to those that need them, when and where needed, with minimum waste of resources
• Health services may be delivered in the home, community, workplace, or in health facilities
• Priorities include packages, delivery models, infrastructure, management, safety, and quality, and demand for care

Health Workforce

• A well-performing health workforce is one that works in ways that are responsive, fair, and efficient to achieve the best health outcomes possible, given available resources and circumstances
• Health workers include all people engaged in actions whose primary intent is to protect and improve health
• Priorities include national workforce policies and investment plans, advocacy, norms, standards, and data

Health Information

• A well-functioning health information system ensures the production, analysis, dissemination, and use of reliable and timely information on health determinants, health system performance, and health status
• There are three domains: health determinants, health systems performance, and health status
• Priorities include facility and population-based information and surveillance systems, and global standards and tools

Medical Products, Vaccines, and Technologies

• A well-functioning health system ensures equitable access to essential medical products, vaccines, and technologies of assured quality, safety, efficacy, and cost-effectiveness
• Priorities include norms, standards, policies, reliable procurement, equitable access, and quality

Health Financing

• A good health financing system raises adequate funds for health, ensuring people can use needed services and are protected from financial catastrophe or impoverishment
• It provides incentives for providers and users to be efficient
• The three interrelated functions are: revenue collection, pooling of pre-paid revenues, and purchasing
• Priorities include national health financing policies, tools and data on health expenditures, and costing

Leadership/Governance/Stewardship

• Leadership and governance involve ensuring strategic policy frameworks exist and are combined with effective oversight, coalition-building, regulation, attention to system-design, and accountability
• Priorities include health sector policies, harmonization and alignment, oversight and regulation

ASEAN – A Regional Body for Health Governance

• The ASEAN way involves consensus-based decision-making and non-interference in the internal affairs of member countries
• Sovereignty lies at the heart of the ASEAN way
• Challenges include a lack of economic commitment and resources, limited data collection and analysis, and coordination with WHO
• ASEAN's objective is to organize a learning process to promote the exchange of experiences and best practices

ASEAN Overview

• Founded on August 8, 1967, by Indonesia, Malaysia, the Philippines, Singapore, and Thailand
• Enlarged to include Brunei Darussalam (1984), Viet Nam (1995), Lao PDR and Myanmar (1997), and Cambodia (1999)
• The ASEAN Charter was established on December 15, 2008, with the ultimate goal of achieving the ASEAN Community in 2015

The Three Pillars of ASEAN

• ASEAN Political-Security Community (APSC) Blueprint 2025: upholds the purpose of preserving regional peace and stability, adopting a comprehensive approach to security and an outward-looking approach in ASEAN external relations
• ASEAN Economic Community (AEC) 2017: promotes the development of a strong healthcare industry, contributing to better healthcare facilities, products, and services
• ASEAN Socio-Cultural Community (ASCC) Blueprint 2025: committed to lifting the quality of life of its people by putting their welfare and well-being at the heart of its activities

ASEAN Healthcare

• Promotes the development of a strong healthcare industry, contributing to better healthcare facilities, products, and services
• Strategic measures:
  • Private healthcare market and Public-Private Partnership (PPP) in universal healthcare in the region
  • Harmonization of standards and conformance in healthcare products and services
  • Promoting sectors with high-growth potential, such as health tourism and e-healthcare services
  • Developing strong health insurance systems in the region
  • Facilitating the mobility of healthcare professionals in the region
  • Developing an ASEAN regulatory framework on traditional medicines and health supplements
  • Developing healthcare product directives to facilitate trade in healthcare products in the region

Challenges

• Sovereignty of member states
• Economic diversity
• Varying regulatory capabilities
• Asian demographic shift: proportion of population by various age groups, transition to ageing population
• Top three challenges facing ASEAN:
  • Health systems
  • Healthcare financing
  • Health workforce

ASEAN Overview

• Founded on August 8, 1967, by Indonesia, Malaysia, the Philippines, Singapore, and Thailand
• Enlarged to include Brunei Darussalam (1984), Viet Nam (1995), Lao PDR and Myanmar (1997), and Cambodia (1999)
• The ASEAN Charter was established on December 15, 2008, with the ultimate goal of achieving the ASEAN Community in 2015

The Three Pillars of ASEAN

• ASEAN Political-Security Community (APSC) Blueprint 2025: upholds the purpose of preserving regional peace and stability, adopting a comprehensive approach to security and an outward-looking approach in ASEAN external relations
• ASEAN Economic Community (AEC) 2017: promotes the development of a strong healthcare industry, contributing to better healthcare facilities, products, and services
• ASEAN Socio-Cultural Community (ASCC) Blueprint 2025: committed to lifting the quality of life of its people by putting their welfare and well-being at the heart of its activities

ASEAN Healthcare

• Promotes the development of a strong healthcare industry, contributing to better healthcare facilities, products, and services
• Strategic measures:
  • Private healthcare market and Public-Private Partnership (PPP) in universal healthcare in the region
  • Harmonization of standards and conformance in healthcare products and services
  • Promoting sectors with high-growth potential, such as health tourism and e-healthcare services
  • Developing strong health insurance systems in the region
  • Facilitating the mobility of healthcare professionals in the region
  • Developing an ASEAN regulatory framework on traditional medicines and health supplements
  • Developing healthcare product directives to facilitate trade in healthcare products in the region

Challenges

• Sovereignty of member states
• Economic diversity
• Varying regulatory capabilities
• Asian demographic shift: proportion of population by various age groups, transition to ageing population
• Top three challenges facing ASEAN:
  • Health systems
  • Healthcare financing
  • Health workforce