scholarly journals 31.F. Workshop: Health system (performance) assessment: working towards a common approach

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health System ◽  
Performance Assessment ◽  
Health Systems ◽  
Universal Health Coverage ◽  
System Performance ◽  
Health System Performance ◽  
Health Coverage ◽  
Health System Performance Assessment ◽  
Health Systems Performance ◽  
Universal Health

Abstract Since the publication of the World Health Report 2000, which aimed at assessing health systems performance globally, a number of health systems performance assessment (HSPA) frameworks and tools, designed for various purposes, have emerged. In 2017, the joint Universal Health Coverage 2030 Technical Working Group on Health Systems Assessment (TWG), consisting of health policy makers and global actors, such as the WHO, World Bank, USAID, Unicef, European Commission, OECD, etc., was formed with the aim to align the existing tools and develop a common approach to understanding and measuring health systems performance globally. As part of this work, the European Observatory on Health Systems and Policies (OBS) has developed a Health Systems Performance Assessment framework for Universal Health Coverage (HSPA Framework for UHC), that allows to evaluate health system performance, largely by drawing on the information available in the existing tools or through global data collection initiatives. Suggested approach is based on the detailed assessment of the four health system functions (governance, financing, resource generation and service delivery) and their sub-functions, the interaction of which jointly leads to the successes and failures in the achievement of health system goals. We propose distinct assessment areas for specific functions and sub-functions as a way to identify potential strengths and weaknesses, which can then be related to actions or responsibilities of specific actors within a health system, or linkages to other sectors. The objective of the workshop is to introduce the background, rationale, methods and process of developing of the HSPA framework for UHC; present a systematic approach to assessing various functions of health system and their interactions; relate the assessment areas of specific functions and sub-functions to the final health system goals; and, finally, to test the use of the framework in practice. The workshop is structured as follows: the workshop will start from the four 10-minute presentations (outlined below), followed by an interactive session with the audience to discuss the content of the framework and elaborate on its potential use for HSPA and applications globally. Key messages The HSPA framework for UHC is an approach that allows to bring together existing HSPA efforts and moves towards a more systematic and universally applicable health system performance assessment. The approach assesses performance through attribution of various health system outcomes to specific functions and sub-functions, allowing to identify strengths and weaknesses that affect performance.

scholarly journals 9.I. Workshop: Health systems performance – making the links between what we do and what we want to achieve

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
◽  
Keyword(s):  
Health System ◽  
Performance Assessment ◽  
Health Systems ◽  
System Performance ◽  
System Analysis ◽  
Health System Performance ◽  
Health System Performance Assessment ◽  
Sources Of Variation ◽  
Specific Assessment ◽  
Health Systems Performance

Abstract   In this session, WHO together with the UHC2030 Technical Working Group on Health System Assessment and the European Observatory on Health Systems and Policies discuss the main elements of their joint approach to HSPA. The workshop intends to propose a common and practical framework that links descriptive health system analysis with evaluation, focussing on health system outcomes. The framework's approach to uncovering health system challenges and bottlenecks and the sources of variation will be discussed - showcasing how Health System Performance Assessment can be used as a means to uncover sources of health system inefficiencies and inequities. The workshop intends to identify the links between intermediate and ultimate goals and relate these to specific actions and actors within a health system, thus providing policy makers with an actionable tool to assess performance. The session is structured into two parts. In the first part the process of developing the HSPA framework and the framework itself will be introduced. The presentation will provide insights into the joint framework based on health system functions and emphasise the links to the intermediate and final goals of the HSPA framework. This will be followed by four short case studies pertaining to the four functions - governance, financing, resource generation and service delivery - and linking specific assessment areas to intermediate and final goals. The second part is an interactive discussion, to be kicked off by the input of Kanitsorn Sumriddetchkajorn and moderated by Josep Figueras, to jointly identify the strengths and weaknesses in performance of a given health system. Key messages Health Systems Performance Assessments should focus on what health systems do and how well, rather than on what they are. Health System Performance Assessment should focus on performance and use their evaluative angle to get to the root causes of not achieving final health system goals.

scholarly journals Engaging citizens in the co-production of a health system performance assessment framework: a case study in Ireland

2021 ◽  
Author(s):  
Óscar Brito Fernandes ◽  
Erica Barbazza ◽  
Damir Ivanković ◽  
Tessa Jansen ◽  
Niek Klazinga ◽  
...  
Keyword(s):  
Health System ◽  
Performance Assessment ◽  
Performance Measures ◽  
System Performance ◽  
Professional Associations ◽  
Third Party ◽  
Added Value ◽  
Future Research ◽  
Health System Performance ◽  
Health System Performance Assessment

Abstract Background The launch in 2017 of the Irish 10-year reform programme Sláintecare represents a key commitment in the future of the health system. An important component of the programme was the development of a health system performance assessment (HSPA) framework. In 2019, the Department of Health of Ireland (DoH) and Health Service Executive (HSE) commissioned the technical support of researchers to develop an outcome-oriented HSPA framework, which should reflect the shared priorities of multiple stakeholders, including citizens. This study describes the method applied in the Irish context and reflects on the added value of using a citizen panel in the co-production of an HSPA framework. Methods A panel of 15 citizens was convened, recruited by a third-party company using a sampling strategy to achieve a balanced mix representing the Irish society. Panelists received lay-language preparatory materials prior to the meeting. Panelists used a three-color scheme to signal the inclusion and importance of performance measures. An exit questionnaire was administered to understand how participants experienced being part of the panel. The citizen panel was the first in a series of three panels towards the development of the HSPA framework, followed by panels including representatives of the DoH and HSE, and representatives from professional associations and special interest groups. Results The citizen panel generated 249 health performance measures ranging across 13 domains. Domains assessed as the most important included people-centeredness, coordination of care, and coverage. Prioritization of domains differed between panels. Citizen panelists shared a similar understanding of what a citizen panel involves and described their experience at the panel as enjoyable, interesting, and informative. Conclusions The engagement of citizens early on in the co-production process of the HSPA framework shaped the processes that followed, with the restating of priorities of the citizen panel informing decision-making throughout. Citizen engagement in HSPA development is essential for realizing value-based people-centered health systems and assuring an inclusive process that helps to generate trust and ownership of performance intelligence. Future research could expand on how citizen panels could be further engaged in co-creating mechanisms to assess, monitor, and report on the performance of health care systems.

scholarly journals A critique of the Uganda district league table using a normative health system performance assessment framework

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Christine KirungaTashobya ◽  
Freddie Ssengooba ◽  
Juliet Nabyonga-Orem ◽  
Juliet Bataringaya ◽  
Jean Macq ◽  
...  
Keyword(s):  
Health System ◽  
Performance Assessment ◽  
System Performance ◽  
Health System Performance ◽  
League Table ◽  
Assessment Framework ◽  
Health System Performance Assessment

Scorecards for health system performance assessment: The New Zealand example

Health Policy ◽  
2011 ◽  
Vol 103 (2-3) ◽  
pp. 200-208 ◽  
Author(s):  
Robin Gauld ◽  
Suhaila Al-wahaibi ◽  
Johanna Chisholm ◽  
Rebecca Crabbe ◽  
Boomi Kwon ◽  
...  
Keyword(s):  
New Zealand ◽  
Health System ◽  
Performance Assessment ◽  
System Performance ◽  
Health System Performance ◽  
Health System Performance Assessment

21.G. Round table: Strengthening national level health systems governance

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health Care ◽  
Health System ◽  
Eastern Europe ◽  
Health Systems ◽  
Universal Health Coverage ◽  
National Level ◽  
Health Coverage ◽  
Policy Makers ◽  
Universal Health ◽  
Health Systems Governance

Abstract Very often, important health system reforms are delayed, rendered ineffective or they simply go badly wrong. All too often this happens not because of a lack of money, health workers or health care facilities but because we adopt unfit ideas and decision and/or implement them insufficiently. The incapacity to develop, adopt and implement good decision is quintessentially the definition of bad governance. If we are to develop our health systems towards Universal Health Coverage and health systems performance improvement, we will need to strengthen our health system governance. Governance is vitally important to health systems reform and refers to how decisions are made and implemented - everything from the ability of policy-makers to take evidence-based and relevant decisions to their ability to implement policies and create alignment between different actors. In this workshop we will share experiences from a governance spring course for policy makers from Eastern Europe and Central Asia. Connected to this we will also share preliminary results of a study on National Level Health Systems Governance. The panelists will address five key issues The contribution of governance to Universal Health Coverage. This contribution will focus on a) the concept of governance defined as the way societies make and implement collective decisions and b) its 5 main domains including transparency, accountability, participation, integrity and capacity. (S Greer)Governance improvement needs in Eastern Europe and Central Asia: experiences from working with policy makers including countries like Azerbaijan, Georgia, Kyrgyzstan, Moldova Tajikistan, Ukraine and Uzbekistan. For purpose of peer-learning and contrasting experiences we have paired these countries with policy makers from Austria, Finland and Ireland (G Pastorino)Stakeholder participation in decision making and implementation: Very often, powerful stakeholders, like the medical profession, is over-represented and exerts immense veto power, while the voice of other professions, patients, and citizens remained unheard. What are the governance strategies and instruments to harness those underrepresented stakeholders for Universal Health Coverage? (G Fattore)Governing centralized and decentralized budgets in primary, social and hospital care: population-based health care in larger countries requires decentralization of part of the health care budget. What are the accountability lines and instruments that ensure that regional and local budget holders aligning with national policies for Universal Health Coverage? (L Hawkins)Governance contribution addressing corruption: According to surveys health systems are perceived prone to corruption. What is the contribution of governance to heal corruption and make the system work according to rules? (D Clarke) Key messages If we are to make progress towards Universal Health Coverage, we will need to strengthen health systems governance. Without strengthening health systems governance we will fail to manage stakeholders, budgets and corruption.

Health workers and health systems

2018 ◽  
pp. 40-43
Author(s):  
Kate Mandeville ◽  
Ingrid Wolfe
Keyword(s):  
Health System ◽  
Health Systems ◽  
Universal Health Coverage ◽  
Health Workers ◽  
Critical Role ◽  
Good Health ◽  
Health Coverage ◽  
Historical Factors ◽  
Equity Of Access ◽  
Universal Health

This chapter describes the critical role that health workers and strong health systems play in improving maternal and child health. A strong health system should deliver improved health, financial protection, equity of access, and a responsive service. Delivering these goals relies on strengthening all parts of the health system, in the context of social, political, and historical factors. There are many lessons to be learned from country experiences, including the importance of universal health coverage and investment in health workers. Universal health coverage is vital for ensuring good health for all; however, both establishing and expanding such coverage is fraught with challenges. Health workforces need to be aligned to a country’s population and disease burden, with retention of health workers given as much priority as increased production. Strengthening health systems is an essential part of the global effort to safeguard health for mothers and children, now and in the future.

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