What are the Health System Building Blocks?
A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health. Like any other system, it is a set of inter- connected parts that have to function together to be effective.
A health system is composed of many parts. In particular: Patients, Families, Communities, Ministries of Health, Health providers and, Health financing bodies
Each component has interconnecting roles and functions. This is why systems thinking is critical – if you look at one component in isolation, you will miss the many ways that that component interacts with the other components.
The interconnecting roles and functions (right side) of the components of a health system (left side)
The Six Health System Building Blocks
The World Health Organization recommends supporting and strengthening a health system based on the below framework (Figure 2). When you strengthen a health system, you improve the six health system building blocks and manage their interactions in ways that achieve more equitable and sustained improvements across health services and health outcomes. PEOPLE are often listed as the seventh building block. “People” refers to individuals, households, and communities as civil society, consumers, patients, payers, and producers of health through knowledge, attitudes, behaviors, and practices.
The WHO’s Health System Framework (Source: World Health Organization. Everybody’s Business: Strengthening health systems to improve health outcomes—WHO’s Framework for Action. Geneva: WHO, 2007, page 3
Strengthening a health system takes a long time. Efforts must be tailored to a specific country. Donors must be coordinated. Everyone involved must be committed to a long- term process. Here is a basic checklist for what to think about when you analyze the building blocks and plan to strengthen them in your own country:
Service Delivery. Good service delivery comprises quality, access, safety and coverage.
Health Workforce. A well-performing workforce consists of human resources management, skills and policies.
Health Information System. A well performing system ensures the production, analysis, dissemination and use of timely and reliable information.
Medical Products. Procurement and supply programs need to ensure equitable access, assured quality and cost-effective use.
Financing. A good health financing system raises adequate funds for health, protects people from financial catastrophe, allocates resources, and purchases good and services in ways that improve quality, equity, and efficiency.
Leadership and Governance. Effective leadership and governance ensures the existence of strategic policy frameworks, effective oversight and coalition- building, provision of appropriate incentives, and attention to system design, and accountability.
