Other Health System Components
Human resources for health is not only the most expensive component of the health system (HRH constitutes about 70% of health care costs in most countries) but also the most important ingredient in delivering better health services that are equitable, effective, efficient and accessible. However, the impact that an improved health workforce has on services, and thus on health outcomes, may be limited if other health system components essential to health worker productivity remain underdeveloped. Therefore, although the main focus of this website is HRH, it is important to identify and acknowledge the importance of other components, apart from human resources, that are critical for better health services.
According to the WHO, the critical health system components that need to be in “good working order” to render equitable and sustained improved services are Policy, Financing, Human Resources, Supply Systems, Service Management and Information and Monitoring Systems.1
Policy (later changed by WHO to Leadership and Governance/Stewardship2) refers to the strategic direction set by senior policy makers to protect public health and safety, control corruption and contribute to effective leadership of the country’s health sector. It includes the legislative, regulatory and policy-making processes; incentives and sanction mechanisms; adjudication systems; and coordination/harmonization with other donors or public sector actors to ensure equitable and sustained health services.
Financing refers to the mobilization, collection, pooling and distribution of health resources to improve their allocation and utilization, maximize outcomes, equity and health status and protect citizens from catastrophic health expenditures.
Supply Systems/Pharmaceutical and Commodity Management refers to the national system to provide drugs and commodities that includes drug policy development, registration and regulation, quality assurance/control mechanisms, as well as drug and commodity selection, quantification, procurement, warehousing and distribution.
Service Management refers to improving the organization, management and quality of services. The organization of services refers to the development and implementation of models of care that promote effective delivery of high-quality services at the appropriate level (community, primary, secondary, tertiary) and reduce segmentation of care. Activities may also focus on referral networks or systems between service levels and mechanisms for quality improvement. Management takes place at many different levels in the health system, and weaknesses in management can make services less effective and waste resources.
Information and Monitoring Systems refers to the collection and analysis of accurate routine health information for management decision making. This includes development of national surveillance systems and surveys; the design of program reporting forms and standard medical record forms for accurate reporting of health services statistics; and development of skills in data analysis and decision making at various levels.
1 World Health Organization. Opportunities for global health initiatives in the health system action agenda. Working paper no. 4. Geneva, Switzerland: World Health Organization, 2006.
2 “WHO and Health Systems: Everybody’s Business” WHO HQ seminar, Geneva, 17 October 2006.