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Assessing National Health Systems: Why and How.

Sara Bennett1, David H Peters1

  • 1Department of International Health ; Johns Hopkins University Bloomberg School of Public Health ; Baltimore , MD USA.

Health Systems and Reform
|September 15, 2019
PubMed
Summary

National health systems assessments (HSAs) serve four key purposes: driving reform, aligning stakeholders, tracking performance, and enabling cross-country learning. Effective HSAs must be relevant, trustworthy, and coherent.

Keywords:
HSA, Health Systems AssessmentLMIC, low and middle-income countryMDG, Millennium Development Goalhealth reformhealth system assessment methodshealth systems assessmenthealth systems performance

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Area of Science:

  • Health Policy and Systems Research
  • Global Health

Background:

  • Health systems assessments (HSAs) are crucial for evaluating and improving national health systems.
  • Understanding the diverse rationales and guiding principles for HSAs is essential for their effective implementation.

Purpose of the Study:

  • To identify the primary rationales for conducting national health systems assessments.
  • To propose a set of guiding principles for the design and execution of HSAs.
  • To emphasize the need for tailored approaches to HSAs based on their intended use.

Main Methods:

  • Systematic review of national health systems assessments.
  • Analysis of the identified rationales and proposed guiding principles.

Main Results:

  • Four primary rationales for HSAs were identified: motivating reform, promoting harmonization, tracking performance, and facilitating cross-country learning.
  • Key principles for HSAs include relevance, trustworthiness, and coherence.
  • No single standardized framework is suitable for all HSAs due to diverse rationales.

Conclusions:

  • HSAs are multifaceted tools with distinct purposes, requiring tailored frameworks and stakeholder engagement.
  • Selecting appropriate frameworks and tools based on the intended use is critical for successful HSAs.
  • Developing local capacity and ensuring stakeholder involvement are vital for effective health systems assessment.