Strengthening health systems by health sector reforms

Abstract

BackgroundThe rising burden of disease and weak health systems are being compounded by the persistent economic downturn, re-emerging diseases, and violent conflicts. There is a growing recognition that the global health agenda needs to shift from an emphasis on disease-specific approaches to strengthening of health systems, including dealing with social, environmental, and economic determinants through multisectoral responses.MethodsA review and analysis of data on strengthening health sector reform and health systems was conducted. Attention was paid to the goal of health and interactions between health sector reforms and the functions of health systems. Further, we explored how these interactions contribute toward delivery of health services, equity, financial protection, and improved health.FindingsHealth sector reforms cannot be developed from a single global or regional policy formula. Any reform will depend on the country's history, values and culture, and the population's expectations. Some of the emerging ingredients that need to be explored are infusion of a health systems agenda; development of a comprehensive policy package for health sector reforms; improving alignment of planning and coordination; use of reliable data; engaging ‘street level’ policy implementers; strengthening governance and leadership; and allowing a holistic and developmental approach to reforms.ConclusionsThe process of reform needs a fundamental rather than merely an incremental and evolutionary change. Without radical structural and systemic changes, existing governance structures and management systems will continue to fail to address the existing health problems.

Interprofessional Fellowship Training for Emerging Global Health Leaders in Africa to Improve HIV Prevention and Care: The Afya Bora Consortium

“…Effective leadership has been identified as key to promoting health care reform in low income countries (Senkubuge, Modisenyane, & Bishaw, 2014). A recent systematic review of transformational leadership training for physicians revealed few interprofessional and transprofessional training programs in the United States and no such programs in Africa (Straus, Soobiah, & Levinson, 2013).…”

Spatially Enabling the Health Sector

“…Senkubuge and colleagues (3) argue that there is no single global or regional policy formula for health sector reform and that it will depend on a country’s history, values, and culture. On the one hand, many developed countries are approaching health reform from a cost-efficiency perspective, aiming to reduce costs while maintaining quality of care and improvements in longevity.…”

Assessment of impediments affecting health systems response to neurocysticercosis in two districts (Gulu and Amuru) of Northern Uganda: A cross sectional study

“…There is growing evidence that the global health agenda needs to shift from an emphasis on disease-specific approaches of interventions to strengthening of health systems, including dealing with social, environmental and economic determinants through multi-sectorial responses (Lancet, 2004;Senkubuge et al, 2014). The World health Organizations (WHO) defines health systems as all organizations, people and actions whose primary intent is to promote, restore and maintain health (WHO, 2008).…”

“…The health systems framework consists of six building blocks, namely; service delivery, health work force, health information systems, medical products including vaccines and other technologies, health financing, leadership and governance (WHO, 2007). These building blocks interact with other facets to constitute a system (Senkubuge et al, 2014). Improvement of healthcare service delivery requires synergies in the functionality of the building blocks at all levels of implementation including the district (Sengkubuge et al, 2014).…”