What Is A Good Health System?
Photo By: CDC Global. (CC by 2.0)
“What is a health system, after all? What is a good one? Is there a good one?” I get these questions all the time. Do you?
It is hard for most people to understand what a health system is. Many people have only experienced one part of the system (when they had to buy insurance, or go see a doctor when sick) while some live in countries where no real functional system exists.
A Health System, that is a good one, is much more. It is how a nation organizes itself to protect and fulfill the right to health of every citizen. It includes providing them with public health services and medical care services, some of these services are more visible and understood than others. For example, the surveillance of a number of frequent transmissible and non-communicable conditions that are most prevalent in a country is an important public health service that citizens usually are not aware of. Most healthcare providers know about it because they have to report to the surveillance system and get reports on the distribution of various diseases and their frequency, alerting them of a possible epidemic.
Most people are aware of the medical services the community needs, if they have received the right health education. For example, if health education is successful, it will be known that pregnant women need to have at least 4 antenatal visits; children need to have a number of vaccines in their first year of life; and one should know to get tested for certain diseases in order to detect them early and get treatment, such as HIV/AIDS, diabetes, breast or prostate cancer.
It is hard to put public health and medical care services together as part of health system. You see, a health system is managed through a number of programs that include the public health and medical care services required to prevent, diagnose and treat the conditions prevalent in a country. Programs are managed by professionals in the Ministry or Department of Health in that country and implemented through a number of professionals working in public and private hospitals and clinics. Programs are designed using the latest scientific evidence to ensure people have access to best quality of care possible.
So, what is a good health system? A good system is one that organized in a way to ensure timely access to the highest attainable standard of care to all its citizens; one that has the right programs managed by competent professionals; one in which clinics provide preventive and curative care for the most common conditions, i.e. primary health care in facilities or in the community where people live. All this is done in accordance with the respective program norms and standards. A good system is one where hospitals to which patients are referred, deliver secondary or tertiary level of care as defined in the country’s programs.
It is simple, but difficult because most countries lack well designed programs or the management capacity to implement them making the best of all the resources they have and they do not have a plan to get there. That is what I was talking about this week in Johannesburg to a group of international development colleagues. I will share their response next week. What do you think a good health system is?
