Greater than the Sum
By Dykki Settle
WHO defines six building blocks of a health system: service delivery, health workforce, information, commodities (products, vaccines and technologies), financing and leadership/governance. The health systems approach puts the emphasis not just on the components of the health system, but the relationships within and between the building blocks. Core to health systems strengthening (HSS) is the idea that none of these building blocks can stand alone, all are necessary for better health outcomes. Changes in one area have repercussions elsewhere. Improvements in one area can't be achieved without contributions in another.
Information and communication technology (ICT) has a powerful role to play in illuminating these relationships, mitigating unexpected negative impacts to the health system, and maximizing positive ones. ICT can be most powerful in the essential role of health systems surveillance, supporting efforts to monitor and measure the strength of health systems and the success of HSS activities.
Health systems strengthening must be attentive, iterative and responsive to change. This can only be achieved through routine surveillance of health and health systems. The concept and discipline of health surveillance, well established and explored by the disease surveillance community, is taking advantage of the growing availability and support of ICT in low-resource environments to monitor and respond to all aspects of health.
