Lecture 2_20240610.pdf

Building Blocks of the Health System 07 June 2024 Health System ❏ WHO (2000): Health systems can be understood “as comprising all the organizations, institutions and resources that are devoted to producing health actions.” ❏ WHO (2007): The health system “consists of all organiza...

Building Blocks of the Health System 07 June 2024 Health System ❏ WHO (2000): Health systems can be understood “as comprising all the organizations, institutions and resources that are devoted to producing health actions.” ❏ WHO (2007): The health system “consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health” as well as compensating for permanent disabilities, regardless of whether health agents are public, governmental, nongovernmental, or private. Health System ❏ Figueras and McKee (2012): A health system includes three items: ❏ The delivery of (personal and population-based) health services, including primary and secondary prevention, treatment, care, and rehabilitation; ❏ The activities to enable the delivery of health services, specifically the functions of finance, resource generation, and stewardship; and ❏ Stewardship activities aimed at influencing the health impact of relevant interventions in other sectors, regardless of whether or not the primary purpose of those interventions is to improve health. Building Blocks of Health Systems ❏ Original objectives: ❏ Promote common understanding ❏ Address new challenges and set priorities ❏ Address questions of health system financiers ❏ Strengthen WHO’s role in health systems, in a changing world ❏ Health systems are considered to be an intermediate social determinant of health (WHO, 2008) which means that the health system at its own cannot explain inequities in health. Source: World Health Organization (2007) Service Delivery ❏ Good health services are those which deliver effective, safe, quality personal and non-personal health interventions to those that need them, when and where needed, with minimum waste of resources. ❏ What are these services: prevention, treatment or rehabilitation ❏ Where are these services delivered: may be delivered in the home, the community, the workplace or in health facilities ❏ Priorities: packages; delivery models; infrastructure; management; safety & quality; 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 (i.e. there are sufficient staff, fairly distributed; they are competent, responsive and productive). ❏ Health workers are all people engaged in actions whose primary intent is to protect and improve health. ❏ Health service providers and health management and support workers ❏ Includes private as well as public sector health workers; unpaid and paid workers; lay and professional cadres ❏ Priorities: national workforce policies and investment plans; advocacy; norms, standards and data Source: ASEANstats.org Health Information ❏ A well-functioning health information system is one that ensures the production, analysis, dissemination and use of reliable and timely information on health determinants, health system performance and health status. ❏ Three domains: on health determinants; on health systems performance; and on health status ❏ Priorities: facility and population based information & surveillance systems; global standards, 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, and their scientifically sound and cost-effective use. ❏ Priorities: norms, standards, policies; reliable procurement; equitable access; quality Health Financing ❏ A good health financing system raises adequate funds for health, in ways that ensure people can use needed services, and are protected from financial catastrophe or impoverishment associated with having to pay for them. It provides incentives for providers and users to be efficient. ❏ Three interrelated functions: the collection of revenues – from households, companies or external agencies; the pooling of pre-paid revenues in ways that allow risks to be shared – including decisions on benefit coverage and entitlement; and purchasing, or the process by which interventions are selected and services are paid for or providers are paid. ❏ Priorities: national health financing policies; tools and data on health expenditures; costing Leadership/Governance/Stewardship ❏ Leadership and governance involves ensuring strategic policy frameworks exist and are combined with effective oversight, coalition-building, regulation, attention to system-design and accountability. ❏ Priorities: health sector policies; harmonization and alignment; oversight and regulation ASEAN – a regional body for health governance ❏ The “ASEAN Way” ❏ A consensus based decision–making and non-interference in the internal affairs of member countries (Heller, 2005) ❏ Sovereignty lies at the heart of the ASEAN way (Howe & Park, 2017) ❏ “…respect for independence, sovereignty, equality, territorial integrity and national identity of all ASEAN Member states; and noninterference in the internal affairs of ASEAN member states; respect for the right of every Member State to lead its national existence free from external interference, subversion and coercion” (ASEAN Charter, 2008, p. 6) ASEAN – a regional body for health governance ❏ Challenges ❏ The main limitation to cooperation for health is a lack of economic commitment and thus resources for ASEAN to act on its ASCC blueprint and priorities in health (Lamy & Phua, 2012) ❏ The objective is not to prescribe uniform rules or to deliver policy outcomes, but to organise a learning process in order to promote the exchange of experiences and best practices (Regent 2003) ❏ Another challenge for ASEAN is the quality of data collection and analysis ❏ Coordination with WHO? But the ASEAN is structurally split between the regional offices of WHO South-East Asia Regional Office (SEARO - IN, MM, TH, TL) and WHO Western Pacific Regional Office (WPRO - BD, KH, LA, MY, PH, SG, VN) Discussion Groups ❏ Please sit with your groupmates for the concept paper. ❏ Guide Questions for the Concept Paper: ❏ Identify a health policy concern in the ASEAN region today. ❏ What makes this health challenge a regional concern? ❏ Remember that you output is only a 300-word paper.