Trial version, Version d'essai, Versão de teste

Health system outcomes

From AHO

Jump to: navigation, search

Health systems have multiple goals.[1] The world health report 2000[2]defined overall health system outcomes or goals as improving health and health equity in ways that are:

  • responsive
  • financially fair
  • make the best, or most efficient, use of available resources.

There are also important intermediate goals: the route from inputs to health outcomes is through achieving greater access to, and coverage for, effective health interventions without compromising efforts to ensure provider quality and safety.

The health systems access framework[3]

Countries try to protect the health of their citizens. They may be more or less successful, and more or less committed, but the tendency is one of trying to make progress, in three dimensions:

  • First, countries try to broaden the range of benefits (programmes, interventions, goods, services) to which their citizens are entitled.
  • Second, they extend access to these health goods and services to wider population groups and ultimately to all citizens: the notion of universal access to these benefits.
  • Finally, they try to provide citizens with social protection against untoward financial and social consequences of taking up health care. Of particular interest is protection against catastrophic expenditure and poverty.

In health policy and public health literature, the shorthand for these entitlements of universal access to a specified package of health benefits and social protection is universal coverage.

This section on Health system outcomes is structured as follows:


Analytical summary

The advance of HIV/AIS pandemic and re-emergence of TB has not only overstretched the capacity of the established Primary Healthcare (PHC) structures and institutions making them susceptible in terms of ability to cope and produce positive results. This has also brought in the challenge of vertical programming of health services. A negative trend in PHC indicators has been observed in the country since the mid-90.

This trend is likely to continue until a negative trend is observed in terms of HIV/AIDS, TB and non-communicable diseases. HIV and TB have diverted both human and financial resources away from other PHC interventions which were adequately supported before.

The country has been faced with significant epidemiological transition from water-borne and sanitation related morbidities and mortalities to lifestyle related morbidities and mortalities. Lifestyle related diseases, related NCD’s and communicable diseases such as HIV and AIDS and TB have put a heavy strain on healthcare services. Clearly, there are more sick people in the country of late than any other time before.

The interplay within communicable diseases such as HIV/TB co-infection and between communicable diseases and non-communicable diseases such as diabetes and some cancers have equally worsened the situation. The reality now is that the country is dealing with a population cohort suffering from incurable illnesses such as HIV and AIDS, MDR/XDR TB, Diabetes, Hypertension and cancers. While treatment approaches as means for diseases control may seem to relieve short term suffering, this approach faces long term sustainability.

General overview and systemic outcomes

Priorities and ways forward


Endnotes: References, sources, methods, abbreviations, etc.

  1. Everybody’s business. Strengthening health systems to improve health outcomes. WHO’s framework for action (pdf 843.33kb). Geneva, World Health Organization, 2007
  2. The world health report 2000. Health systems: improving performance (pdf 1.65Mb). Geneva, World Health Organization, 2000
  3. The world medicines situation (pdf 1.03Mb). Geneva, World Health Organization, 2004