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From «Planning» to «Systems Analysis»: Health services strengthening at the World Health Organisation, 1952-1975
Martin Gorsky1, Christopher Sirrs1
1Centre for History in Public Health. London School of Hygiene and Tropical Medicine.
Dynamis (Granada, Spain)
|February 21, 2020
Summary
The World Health Organisation
Area of Science:
- Global Health Policy
- Health Services Administration
- History of International Health
Background:
- Conventional understanding suggests the World Health Organisation (WHO) prioritized disease-specific programs over local capacity building until 1978.
- This article examines the less-discussed history of WHO's early advisory work on health services planning and administration.
- Existing institutional histories offer limited analysis of this crucial period.
Purpose of the Study:
- To investigate the intellectual and policy history of health services planning and administration within the WHO's early postwar engagement.
- To analyze the evolution of WHO's approach to health services strengthening from the 1950s to the 1970s.
- To understand the factors influencing WHO's engagement with member states on health system development.
Main Methods:
- Review of secondary literature on WHO's early history and international health.
- Chronological analysis of WHO's health services planning and administration initiatives from the 1950s to the 1970s.
- Examination of the influence of external political sensitivities and prevailing development paradigms.
Main Results:
- The 1950s saw WHO promoting Western organizational models and later planning techniques, influenced by European social medicine but excluding social security and rights.
- In the 1960s, health planning was integrated into economic development, focusing on infrastructure and labor, but failed due to neglect of financing and capacity, and entanglement with soft power.
- The 1970s introduced systems analysis, offering a technocratic, apolitical approach to health policy that ultimately proved ineffective in real-world settings.
Conclusions:
- Early WHO efforts in health services strengthening were shaped by geopolitical considerations and Western technical models, often neglecting crucial aspects like financing, rights, and local context.
- The evolution from social medicine ideals to technocratic planning ultimately failed to build sustainable health services capacity.
- A deeper understanding of this history is vital for contemporary global health policy and practice.
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