the health system

8/3/2019 The Health System

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THE HEALTH SYSTEMTHE HEALTH SYSTEMSystem a set of interrelated and independent parts thatform a complex whole and each of these parts can beviewed as a subsystem with its own set of interrelated andindependent parts.

Health system the interrelated ways in which thecountry organizes available resources for the maintenance

and improvement of the health of its citizens andcommunities .

The system includes a health infrastructure which deliversa variety of health programs and provides

health care to individual families and communities.

Such health care consists of a combination of a promotive,

preventive, curative, and rehabilitative measures.


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The health system is usually composed ofThe health system is usually composed ofvarious levels :various levels :

1. Point of contact1. Point of contact between individualsbetween individuals

and system where care is delivered.and system where care is delivered.

2. Intermediate2. Intermediate3. Central3. Central

The latter two provide more specializedThe latter two provide more specializedservices and support.services and support.


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HEALTH SECTORHEALTH SECTOR

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HEALTH STATUSHEALTH STATUS ---------- POPULATIONPOPULATION

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HEALTH RELATED SECTORHEALTH RELATED SECTOR

Health sectorindicates the group ofindicates the group of

services or institutions in the communityservices or institutions in the communitywhich are concerned with the healthwhich are concerned with the healthprotection of the population.protection of the population.


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Functions of the Health SectorFunctions of the Health Sector

1. Direct supervision of health services covering the aspects of promotion,1. Direct supervision of health services covering the aspects of promotion,prevention, diagnosis and treatment and medical / dental rehabilitation.prevention, diagnosis and treatment and medical / dental rehabilitation.

2. Development and provision of health manpower, drugs, medical2. Development and provision of health manpower, drugs, medicalsupplies and financing support schemes.supplies and financing support schemes.

3. Research and development to continuously maintain the relevance and3. Research and development to continuously maintain the relevance andcapability of the present health care system to the evolving national andcapability of the present health care system to the evolving national andlocal situations.local situations.

4. Coordinating , controlling and directing organizations and activities4. Coordinating , controlling and directing organizations and activitiesassociated with other functions.associated with other functions.

The functions enumerated coincide with the generic nomenclature given byThe functions enumerated coincide with the generic nomenclature given byKaluzny et al namely : production, maintenance, adaptive, managerial.Kaluzny et al namely : production, maintenance, adaptive, managerial.


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Programs of the Health SystemPrograms of the Health System These are specific courses of action with assignedThese are specific courses of action with assigned

resources designed to accomplish a given objectives.resources designed to accomplish a given objectives.

Categories:Categories:

a. General Healtha. General Health

b. Tuberculosis Controlb. Tuberculosis Controlc. Malaria Controlc. Malaria Control

d. Maternal and Child Healthd. Maternal and Child Health

e. Family Planninge. Family Planning

f. Environmental Healthf. Environmental Healthg. Nutritiong. Nutrition

h. School Healthh. School Health

i. Oral Healthi. Oral Health


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Financing of the Health SystemFinancing of the Health System

1.1. Users chargesUsers charges-- particularly suited for those aspects ofparticularly suited for those aspects ofhealth care that are considered private goods ,health care that are considered private goods ,benefits of the service accrue directly to the user.benefits of the service accrue directly to the user.Curative services and personal health care fall in thisCurative services and personal health care fall in this

category.category.2.2. Public subsidyPublic subsidy aspect of health care whose benefitsaspect of health care whose benefitsare widely spread . Would also be needed to provideare widely spread . Would also be needed to provideprivate goods such as curative and personal care forprivate goods such as curative and personal care forindigents and lowindigents and low--income segment of population.income segment of population.

3.3. Community financingCommunity financing the most readily availablethe most readily availableresource tapped in community financing is voluntaryresource tapped in community financing is voluntarylabor coupled with mass action of fund raisinglabor coupled with mass action of fund raisingactivities. Effective in environmental sanitation, settingactivities. Effective in environmental sanitation, settingup and maintaining potable water supply facilities.up and maintaining potable water supply facilities.


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Financing of the Health SystemFinancing of the Health System

4.4. Health insuranceHealth insurance more complex and structured form ofmore complex and structured form ofhealth financing based on a system of risk sharing. Thehealth financing based on a system of risk sharing. Themain advantage is the ability to raise revenuesmain advantage is the ability to raise revenuescommensurate with the assuredcommensurate with the assured levels of health costlevels of health costprotection offered to its members by breaking down intoprotection offered to its members by breaking down into

regular smallregular small cost premiums in exchange for assurance ofcost premiums in exchange for assurance offull or substantial coverage of cost or dreaded events suchfull or substantial coverage of cost or dreaded events suchas medical needs.as medical needs.

5.5. Involvement of private sectorInvolvement of private sector company financed healthcompany financed healthbenefits for employees and dependents , sponsorship ofbenefits for employees and dependents , sponsorship ofmedical bills by philanthropic societies, groups ormedical bills by philanthropic societies, groups orindividuals spontaneous or inspired public donations toindividuals spontaneous or inspired public donations tofinance medical or emergency needsfinance medical or emergency needs of disaster victims ,of disaster victims ,special lotteries to raise funds to support operation of aspecial lotteries to raise funds to support operation of amedical facility or services.medical facility or services.


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Health System Based on PrimaryHealth System Based on Primary

Health CareHealth Care 1. The system should encompass the entire1. The system should encompass the entire

population on the basis of equality andpopulation on the basis of equality andresponsibility.responsibility.

2. It should include components from the health2. It should include components from the healthand other sectors whose interrelated actionsand other sectors whose interrelated actionscontribute to health.contribute to health.

3. the essential elements of Primary Health Care3. the essential elements of Primary Health Careshould be delivered at the first point of contactshould be delivered at the first point of contact

between individuals and the health system.between individuals and the health system. 4. The other levels of the health system should4. The other levels of the health system should

support the first contact level to permit it to providesupport the first contact level to permit it to provideessential elements on a continuing basis.essential elements on a continuing basis.


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5. At the intermediate levels more complex problems5. At the intermediate levels more complex problemswould be dealt with more skilled and specialized logisticwould be dealt with more skilled and specialized logisticsupport . More highly trained staff should provide :support . More highly trained staff should provide :

a. continuing training to peripheral health workersa. continuing training to peripheral health workersb. guidance to communities and community healthb. guidance to communities and community health

workers on practical problems arising in connectionworkers on practical problems arising in connection

with all aspects of PHC.with all aspects of PHC.

6. The central level should coordinate all parts of the6. The central level should coordinate all parts of thesystem and provide :system and provide :

a. planning and management expertisea. planning and management expertise

b. highly specialized staffb. highly specialized staff

c. teaching for specialized staffc. teaching for specialized staffd. expertise of central laboratoriesd. expertise of central laboratories

e. central logistics and financial support unitse. central logistics and financial support units


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DISTRICT HEALTH SYSTEMSDISTRICT HEALTH SYSTEMSDistrict as defined by WHO , as the smallestDistrict as defined by WHO , as the smallest

manageable health units in small areas.Thatmanageable health units in small areas.Thathas the ingredients for selfhas the ingredients for self--reliant healthreliant healthcare.care.-- Primary health care facilities in communitiesPrimary health care facilities in communities

-- Referral hospitalReferral hospital-- Laboratory facilitiesLaboratory facilities-- Health office with a full time health officer.Health office with a full time health officer.

The concept is also labeled the first referral levelThe concept is also labeled the first referral levelwhich has the advantage of stressing the need towhich has the advantage of stressing the need tobe close enough to the front line in order tobe close enough to the front line in order toprovide effective backprovide effective back--up for the primary healthup for the primary health

care level.care level.

the health system

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