Key Issues of Health System in Developing

Countries

Presented by:

Nirmala Bista (21)

What is health system?• The term “health system” encompasses the

personnel, institutions, commodities, information, financing and governance strategies that support the delivery of prevention and treatment services.

• Main objectives of a health system are to respond to people’s needs and expectations by providing services in a fair and equitable manner.

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• The World Health Organization defines a health system as “all the activities whose primary purpose is to promote, restore, or maintain health.”

• The World Bank defines health systems more broadly to include factors interrelated to health, such as poverty, education, infrastructure and the broader social and political environment.

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• It is a fairly complex system of inter-related elements that contribute to the health of people - in their homes, educational institutions, in work places, the public (social or recreational) and the psychological environments as well as the directly health and health-related sectors.

• It encompass clean water and sanitation, health-related education, financial sustainability and security, effective management and leadership, and appropriate technology in addition to actual provision of services.

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• Like many complex entities, health systems are influenced by factors such as education, infrastructure, poverty, and the overall social and political environment.

• The performance of a heath system is measured by its scale, scope, distribution, quality, safety and capabilities.

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• In 2007, the World Health Organization (WHO) drafted a framework to guide efforts to strengthen health systems.

• This framework identifies six components needed to establish, sustain and strengthen a health system, while the issues of health system are also identified on the basis of these components:

Key issues of health system

Lack of leadership and good governance: This has imposed a poor policy frameworks upon the people. These policies fail to define the role of State with regard to other players. In this scenario, proper monitoring and management of health programs isn’t possible. Likewise, poor governance results in corruption and social injustice throughout the health sector.

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Inadequate funding of the health system: The total budget allocation for health sector in any developing country is less than 10% of the total budget. This is not enough for providing essential health care services to all citizens.

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• Improper functioning of health information system: There is no production, analysis, dissemination, and use of reliable and timely information on health determinants, health systems and health status. This reduces responsiveness of the concerned authority and stakeholders towards surveying the health problems

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Lack of quality health workforce: The health workforce isn’t properly trained and equipped to provided equitable access to needed health services. This is mainly due to lack of health human resource producing institutions and “brain drain” to an extent. The qualified human resource migrate to developed countries for better income and opportunities.

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Expensive medical products and technologies: Poverty is quite an issue in developing countries. People work hard to make their ends meet. They cannot afford the expensive medical procedures and medications to restore their health.

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Lack of efficient service delivery: There’s lack of co-ordination and management in providing health services to those in need with a minimum wastage of resources. Efficient service delivery is essential to prevent duplication of efforts and maintain a healthy balance of services

Recommendations:

• Develop a plan for health systems with supportive policies and laws with monitoring and evaluation mechanisms

• Leaders should ensure that the ministry of finance releases money in time for health systems to pay salaries, bills and purchase necessary pharmaceuticals.

• Ensure that managers have necessary training and skills for the job and are held accountable for successes or failures.

 

Contd…• Developing risk-pooling insurance schemes,

such as community-based health financing.

• Develop payment and other incentives for providers 

• Develop a plan for human resources; standardize job descriptions, ensure that job duties are clear to employees

• Train workers properly on basic medical and nursing skills; assess knowledge, review performance

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• Ensure that supplies of drugs, antibiotics, diagnostics, gloves, and other necessary commodities are always in stock and they aren’t expired.

• Mass drug administration campaigns; social-marketing methods or free government provision of goods

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• Training and equipping village health teams to provide home-based care where no facilities exist

• Implement clean water and sanitation, environmental safety and health-related education programs, e.g. collaborate with schools to improve access to health and education jointly.