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Health Systems Development

The primary goal of a health system is to promote, restore, or maintain health. A health system comprises organizations, people, and efforts made to improve a population’s health. It is a complex, multi-layered system. Components include publicly owned facilities that deliver personal health services; a mother caring for a sick child at home; private providers; behavior change programs; vector-control campaigns; health insurance organizations; occupational health and safety legislation; as well as inter-sectoral action by health staff, for example, encouraging the ministry of education to promote female education, which is a well-known determinant of improved health.

In many countries, health care workers operate every day in an extremely challenging environment in which lack of infrastructure and necessary policies and guidelines, scarce resources, systemic imbalances and logistical or financial bottlenecks make it difficult for their employers to provide basic equipment and drugs, adequate salaries and support for developing and maintaining their skills and motivation. HIV/AIDS has further exacerbated problems faced by already-stretched human resource systems.

Worldwide, efforts are being made to address and solve the challenges inherent to human resource development in developing countries—within the context of health sector reform. Such reform typically consists of a process of decentralization, expansion of primary and basic care, better use of resources and increased involvement of the community. These necessary processes of sector reform, however, usually create additional burdens for the workforce.

In settings such as these, a strategic and systemic approach is necessary to guide the process of workforce development. This comprehensive framework should incorporate the following key, interconnected programmatic and managerial components operating within the context of the external national and health sector environment.

  • Planning for human resources in health that is realistic in the context of the country
  • Production of human resources with the knowledge, skills and attitudes to provide high-quality health care
  • Deployment of these human resources where they are needed
  • Performance management and support to ensure that these human resources perform effectively
  • Regulation and quality assurance mechanisms 
  • Human resources administration
  • Monitoring and evaluation of outputs and outcomes

Source: World Health Organization (WHO). 2007. Everybody's business. Strengthening health systems to improve health outcomes : WHO’s framework for action. http://www.who.int/healthsystems/strategy/everybodys_business.pdf