Health System Concepts

First and foremost to understand this topic, there need to clearly define terms and concepts.

A health system is defined as all organizations, people and actions whose primary intent is to promote, restore or maintain health the goal of health system are to improving health and health equity in ways that are responsive, financially fair and makes the best or most efficient use of available resources. (World Health Organization, 2007) The health system consists of multiple relationships and interactions among the six building blocks (service delivery, health workforce, health information, medical technologies, health financing and leadership and governance), i.e., how one affects and influences the others, and is in turn affected by them.

(Hold LM, 2005), (Rickles D, 2007), (Bierema LL, 2003) Unfortunately, many systems lack the capacity to understand and or measure their own weaknesses and constraints, leaving policy makers (including the regional medical officer) with no ideas on what they can and should strengthen. Within this complex system, interventions ( such as primary health care services), even the simplest, fail to achieve their intended goals not because of the inherent flaw in interventions itself, but rather to unpredictable behavior of the system around it (e.g., health workers blaming the poor working conditions, the users underusing services due to inadequate or deplorable services provided by the health units and the managers/leaders being part of the system as well as steering the strengthening wheel on supply side). Another example in which one intervention may in on one situation and not another is conditional cash transfer to may increase health seeking where transport to the facilities is available and not another, or it may entrench certain unintended behaviors to maintain status quo for continued eligibility in a mother with malnourished child. (Meadows D, 2008) This case gives us a perfect example of the characteristic of a system, which is constantly changing, tightly connected,

For instance in this case, the poor working conditions has the effect of demotivating the health workers who in turn provide poor quality services, with resultant dissatisfaction of the users who eventually shun the health care units and the end result is decreased service utilization. All these widen the know-do gaps, as well as the health gap with resultant effects on equity, access and decline in