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Cross-Programmatic Efficiency: The System is Greater Than the Sum of Its Programs.
Susan P Sparkes1, Alexandra J Earle1, Joseph Kutzin2
1Health Financing and Economics, World Health Organization, Geneva, Switzerland.
Health Systems and Reform
|December 12, 2024
Summary
Health programs often overlap, hindering efficiency and Universal Health Coverage (UHC). A cross-programmatic efficiency analysis (CPEA) reveals system-wide improvements are needed for better health service delivery and resource alignment.
Area of Science:
- Health Systems Research
- Public Health Policy
- Health Services Management
Background:
- Health programs are crucial for specific services but cannot address holistic health needs.
- Stagnating Universal Health Coverage (UHC) indices raise concerns about program efficiency and sustainability.
- Existing health programs often exhibit duplication and misalignment, impacting overall system performance.
Purpose of the Study:
- To assess health programs using a system-wide perspective through cross-programmatic efficiency analysis (CPEA).
- To identify areas of duplication and misalignment within health systems.
- To inform policy reforms for improved health system efficiency and UHC.
Main Methods:
- Utilized the World Health Organization's cross-programmatic efficiency analysis (CPEA) approach.
- Analyzed programs based on health system functions and system-wide alignment.
- Conducted CPEA in six countries (Bhutan, Ghana, Kenya, South Africa, Sri Lanka, Tanzania) from 2017-2021.
Main Results:
- Identified significant duplication and misalignment across programs in information systems, health workforce, and supply chains.
- Found that financing and governance structures often drive inefficiencies in resource generation (inputs).
- Demonstrated that these inefficiencies directly affect the delivery of health services to individuals.
Conclusions:
- A whole health system approach is critical for enhancing efficiency and achieving UHC objectives.
- Addressing duplications and misalignments in program inputs is essential for improving health service delivery.
- Cross-programmatic efficiency analysis provides a valuable framework for identifying and rectifying systemic inefficiencies in health programs.
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