What is a health system?
A health system is a social-economic structure which includes all those who deliver health care, money flow that finances this flow, drugs and device manufacturers, planners, regulators who control fund, financial intermediaries, ministries of health, finance, planning, Social, private institutions that make health policies and finally the activity of organizations who deliver preventive services such as immunization, family planning, health education. It is important to emphasize that health system is composed of interdependent parts the organizations, money, and people that comprise health systems.
What health system does?
A health system recognizes the root causes of problems in health care and results in long term improvement of quality and coverage of it. In 2000 with the signing of Eight Millennium Development Goals (MDG) for development and poverty eradication by UN has led to growing momentum within field of global health. The ambitious nature of these goals which are supposed to be achieved by 2015 the task seems uphill and almost unachievable now.
The functions of health system are quite elaborate and should do the following
- Provide access to health services, prevention, diagnosis, treatment and rehabilitation
- Protect the sick and their families from financial burden of ill health by establishing some kind of scheme.
- Improve health of masses by appropriate governance of health system, regulation, promotion of good health.
- Raise money that can be spend on health called “Resource Generation”
How to approach Health System Development?
The approach towards health system is a multispectral approach to health development with special attention to low income countries and is known as horizontal approach since it integrates with it all sectors of health systems. But there are lot of critics of health system and who believe in disease- specific approach since results are tangible and can create immediate results. The disease specific approach is a horizontal approach focusing on a disease rather than the entire health system. Issue is when in your country you are facing impoverishment, mortality due a disease, it is difficult to focus on a task whose results cannot be measured or seen in the immediate future. It is better to focus on a “small chunk” rather than taking on the whole health system. So currently health systems face lot of constraints as this approach doesn’t create tangible results that can yield immediate measurable improvements in health status. The efforts put may become unfocused and unmanageable. It’s a long drawn process which tries to improve health systems from bottom up.
Health systems role in MDG
In spite of all the issues involved with the health care system, just handling the disease specific problems and not the issues related to health systems, the MDG goals which UN has set will be an uphill task to achieve. Stronger health systems appear to be a necessary prerequisite to achieve the MDGs. The weak systems will be compromised by the over-concentrating resources on specific programs only leaving many areas under sourced, which will in turn backfire to an already very weak and out of control health system.
By Dr. Mitali Pande