Health System’s Levers
By Nellie Bristol
OFF THE PRESS
The Global Health System: Strengthening National Health Systems as the Next Step for Global Progress
The word "system" conjures up an image of a rational, organized, well-planned operation where cause equals effect and everyone knows ahead of time what the outcome will be. Health systems, however, defy that concept.
They tend to be more akin to living organisms: amorphous, evolving, reactive. They reflect a country's history, political and social structure, and character as much as they do its health needs.
As an example, the United Kingdom's National Health Service grew out of the devastation of health infrastructure caused by World War II. Free-market-loving Americans embrace the most private-sector-oriented system of any developed country while communist Cuba successfully supports cradle-to-grave care for all.
In spite of the quirks and eccentricities inherent in each country's health system, or maybe because of them, the World Health Organization (WHO) attempts to rationalize systems through the development of norms and definitions. It defines a health system as "all the activities whose primary purpose is to promote, restore or maintain health." The definition is meant to include not only health services, but also factors that contribute to overall health promotion, including health education and relevant social structures.
