The Health System
Health systems are defined as comprising all the organizations, institutions and resources that are devoted to producing health actions. A health action is defined as any effort, whether in personal health care, public health services or through intersectoral initiatives, whose primary purpose is to improve health. But while improving health is clearly the main objective of a health system, it is not the only one. The objective of good health itself is really twofold: the best attainable average level – goodness – and the smallest feasible differences among individuals and groups – fairness. Goodness means a health system responding well to what people expect of it; fairness means it responds equally well to everyone, without discrimination
National health systems have three overall goals:
1. good health,
2. responsiveness to the expectations of the population, and
3. fairness of financial contribution.
WHO describes health systems as having six building blocks: service delivery; health workforce; information; medical products, vaccines and technologies; financing; and leadership and governance (stewardship). The 2008 Ouagadougou Declaration on Primary Health Care and Health Systems in Africa focuses on nine major priority areas, namely Leadership and Governance for Health; Health Services Delivery; Human Resources for Health; Health Financing; Health Information Systems; Health Technologies; Community Ownership and Participation; Partnerships for Health Development; and Research for Health.
This section of the analytical profile is structured along the lines of the WHO Framework and the priorities described by the 2008 Ouagadougou Declaration.
As most of SSA countries after their health system’s reform, Zambia based its health system on decentralization. This decentralization led to three levels of public health facilities that are hospitals, health centers, and health posts; moreover, the hospitals are divided into primary (district), secondary (provincial), and tertiary (central) facilities. Incidentally, boards are in place at different level to oversee health activities of their respective levels; this situation relieved the MoH of health service delivery coordination/supervision and focused their role on policymaking and regulation of the health sector
- ↑ Bossert, T. et al., “Decentralization of the Health System in Zambia,”Partnerships for Health Reform, Abt Associates Inc.: Bethesda, MD, 2000.