scholarly journals Is the EU ready for a generic set of indicators for health system performance? A qualitative study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N Perić ◽  
T Ullmann ◽  
M M Hofmarcher ◽  
Z Or ◽  
J Simon
Keyword(s):  
Qualitative Study ◽  
Health System ◽  
Health Systems ◽  
System Performance ◽  
Candidate Country ◽  
Health System Performance ◽  
Member States ◽  
Policy Makers ◽  
Generic Set ◽  
The Eu

Abstract Background As part of the EU funded BRIDGE Health project, 23 headline indicators for assessing and comparing the performance of public health systems were proposed. They were shortlisted out of the currently existing and often overlapping pool of over 2000 health system performance assessment (HSPA) indicators. In this qualitative study, we explored their validity and perceived national-level utility for policy making and factors affecting the potential uptake of an indicator hierarchy (headline, operational & explanatory levels) at Member States' and EU levels. Methods Semi-structured interviews with a purposive sample of 24 policy makers and senior policy advisors from 15 EU Member States and one candidate country were performed between July and November 2018. All interviews were transcribed and coded using summative and directed content analysis to generate thematic categories in MAXQDA. Results Preliminary results suggest that experts positively perceived the overall balance of the shortlist across performance domains reflecting most of the important policy areas. However, some further amendments to the generic set of indicators were recommended to increase their policy relevance and measurement validity while keeping the size manageable. The concept and usage of headline HSPA indicators is mostly viewed as a communication tool whereas more granular information at explanatory levels is perceived to be more appropriate for data driven policymaking and cross-country learning. Conclusions Interviews showed a considerable heterogeneity in the feasibility of applying a generic HSPA framework in an EU-wide health strategy as a compass for improvement through comparisons of health systems. Factors such as flexibility in adaptation to the national context, improvement in building knowledge capacity, potential misinterpretation in the 'European Semester' context, as well as lack of appropriately defined benchmarks were recurrent themes in hindering its uptake. Key messages Policy makers assess explanatory level indicators to be more actionable than headline level indicators. To facilitate the use of headline indicators at EU-level as a navigation tool for health systems, the list has to be stable to create trends and sufficiently flexible in adapting to new priorities.

scholarly journals An evaluation of the global health security agenda steering group governance interventions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N E DeShore ◽  
J A Johnson ◽  
P Malone ◽  
R Greenhill ◽  
W Wuenstal
Keyword(s):  
Global Health ◽  
Health System ◽  
System Performance ◽  
Health System Performance ◽  
Global Health Security ◽  
Member States ◽  
Health Security ◽  
Governance Indicators ◽  
Positive Effect ◽  
Global Health Security Agenda

Abstract Background Member States lack of compliance with 2005 IHR implementation led to the launched of the Global Health Security Agenda. This research will provide an understanding of how the Global Health Security Agenda Steering Group (GHSA SG) governance interventions impact health system performance and global health security. This will enhance the understanding of a Steering Group's governance interventions in complex Global Health initiatives. Research questions: To what extent have GHSA SG governance interventions contributed towards enabling health system performance of WHO Member States? To what extent have GHSA SG governance interventions contributed towards the implementation of global health security among WHO Member States? Methods Correlational analysis using Spearman's rho examined the relationship between governance, health system performance and global health security variables at one point in time. A convenience non-probability sample consisting of eight WHO Member States was used. SPSS Statistics generated the bivariate correlation analyzes. Results Governance and health system performance analysis indicated a statistically significant strong positive effect size in 11 out of 18 and moderate positive effect size in the remaining seven out of 18 health system performance indicators. Governance and global health security analysis concluded three of the governance indicators had strong and moderate positive coefficients. Global health security variables demonstrated weak effects in the remaining three governance indicators. Conclusions This study presents a case for health systems embedding in global health security. Health system performance is only as effective at protecting populations when countries achieve core capacities of preparedness and response to global health threats. The associations provide stakeholders information about key characteristics of governance that influence health system performance and global health security implementation. Key messages This study provides an argument for the continued support of the GHSA 2024 Framework with implementation of global health security capabilities and meeting 2005 IHR requirements. The GHSA SG governance role remains profoundly important in establishing sustainable efforts internationally towards achieving the objectives of the GHSA in support of the 2005 IHR standards.

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.

Evaluating health care systems

2013 ◽  
pp. 428-438 ◽  
Author(s):  
Martin McKee ◽  
Bernadette Khoshaba ◽  
Marina Karanikolos
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Systems ◽  
System Performance ◽  
Health Care Systems ◽  
Health System Performance ◽  
Care Systems

This chapter aims to help the reader understand the importance of defining the boundaries of a health system in a given country, explain the functions of a health system and how these relate to one another, describe the goals of a health system and how to evaluate progress towards them, be aware of the major contemporary initiatives to assess health system performance internationally, and recognize the limitations, including the scope for abuse, of health systems comparisons.

scholarly journals Workshop: Care4Care: the migrant care workforce in Europe

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Health System ◽  
Labour Market ◽  
Health Systems ◽  
Health Workforce ◽  
System Performance ◽  
Migrant Health ◽  
High Income ◽  
Health System Performance ◽  
Health Workforce Governance ◽  
Populist Movements

Abstract Background Foreign trained health workers increasingly fill the care gaps caused by labour market shortage and governance failures. As doctors, nurses and carers they make a crucial contribution to health system performance and the health of the population. These contributions are likely to increase in future, especially in high-income countries, where demographic change and NCDs reinforce the gap between demand for care and labour market supply. However, health system demands for migrant carers do not sit easily with the new wave of nationalism and populist movements in Europe and globally; they may also reinforce the ‘care drain’ in less well-resourced sending countries. There is an urgent need for more inclusive health workforce governance in order to take ‘care’ for the migrant health workforce both nationally and globally and ensure ‘health for all’. Objectives This workshop addresses these questions and fosters critical debate. It has three major aims: to make the migrant carers visible as important part of the health workforce and health system performance, to unmask the threats of growing nationalism and populist movements to healthcare systems and universal healthcare coverage, and finally to critically discuss how to govern the migrant care workforce in ways that improve both integration in the host country and solidarity across Europe and globally. The workshop brings together knowledge and expertise from the areas of health workforce, health services, and health policies and systems. It is organised as round table discussion, facilitated by an overview of migrant care workforce patterns and policies in selected European Union (EU) high-income countries and two in-depth country cases, namely Italy and Austria, both known for growing populism and nationalism and strong anti-migrant policies in the EU. The three panelists will discuss the role of migrant care workers and explore, from different perspectives, how to build capacity for new forms of health workforce governance that move beyond narrowly defined national/regional interests of health systems. The workshop will foster a wider debate on migrant careers and health workforce needs, and how public health can contribute to better take ‘care’ for the human resources for health. Key messages Migrant carers form an important part of the health workforce in European countries. Health systems must take care of the migrant health workforce and counteract growing nationalism.

Building a High-Value Health System

2021 ◽  
Author(s):  
Rifat Atun ◽  
Gordon Moore
Keyword(s):  
Health System ◽  
Health Systems ◽  
System Performance ◽  
Health System Performance ◽  
Case Examples ◽  
System P

Building a High-Value Health System presents a practical, general approach to designing a health system that provides comprehensive, effective, and affordable healthcare for nations across the globe. This book systematically leads readers through the steps of designing a system around a developed country’s needs by describing what a health systems is, how to analyze a country’s health system performance, how to evaluate the needs of a population, how to assess the key capacities available, and how to develop and implement health system improvements tailored to a constituent population. A textually rich workbook drawing on case examples from across the globe, Building a High-Value Health System will provide readers with a deeper understanding of their own health system and provide the framework for the necessary actions toward building a better one.

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 A Reviewing the Top Health Systems with Comparison to Iraqi Health System

2021 ◽  
Vol 63 (1) ◽  
pp. 43-49
Author(s):  
Hazim A Alhiti
Keyword(s):  
Health System ◽  
Health Systems ◽  
System Performance ◽  
Healthcare Systems ◽  
Performance Criteria ◽  
System Model ◽  
Health System Performance ◽  
Weak Points

Background: The assessments of performance in any health system is a challenging goal. Objectives: This article reviews the top healthcare systems then compares them to Iraqi health system. Patients and methods: The top 12 commercial Health Systems in 2020 ranked by a survey of more than 20,000 international citizens from 73 countries on 65 diverse metrics. These metrics vary from simple to critical health system performance criteria. Results: Up to January 2020, the review shows that Canada has the top Health System. Most other top countries are Europeans. There are some strong and weak points in each health system. Iraqi health system struggles with several obstacles that need a rehabilitation. Conclusions: Iraqi health system needs some improvements. The Netherlands Health system model improves the Iraqi health system.

scholarly journals Impact and effect mechanisms of mass campaigns in resource-constrained health systems: quasi-experimental evidence from polio eradication in Nigeria

2021 ◽  
Vol 6 (3) ◽  
pp. e004248
Author(s):  
Marco J Haenssgen ◽  
Svea Closser ◽  
Olakunle Alonge
Keyword(s):  
Health System ◽  
Health Systems ◽  
Service Provision ◽  
System Performance ◽  
Child Survival ◽  
Polio Eradication ◽  
Health System Performance ◽  
Maternal Healthcare ◽  
Global Health Initiatives ◽  
Health Initiatives

BackgroundMass campaigns are a key strategy for delivering life-saving interventions under Global Health Initiatives, especially in weak health system contexts. They are frequently designed parallel to the health system to rapidly achieve programme targets such as vaccination coverage, but we lack quantitative evidence demonstrating their impact and effect mechanisms on health system performance at sub-/national level. This longitudinal study responds to this gap through an analysis of polio eradication campaigns in Nigeria.MethodsUsing four rounds of Demographic and Health Surveys in Nigeria between October 2000 and December 2017, we created a longitudinal dataset containing 88 881 under-5 children/pregnancies. We estimated the relationships between individuals’ campaign exposure and health system performance indices (full RI schedule attainment, maternal healthcare services utilisation and child survival) using multilevel, mixed-effects regression models applied nationally and stratified by the six geopolitical zones in Nigeria.ResultsNationally, high-frequency mass campaigns had detrimental health systems effects that potentially left 3.6 million children deprived of full immunisation. The frequency of campaigns was most concentrated in regions with weak health systems, where the operations of RI were disrupted, alongside negative effects on child survival and institutional delivery. In contrast, regions with relatively strong health systems and few campaigns experienced beneficial effects on maternal healthcare service utilisation.ConclusionsAs we provide evidence that well-functioning health systems can benefit from mass campaigns under Global Health Initiatives, our work also challenges the established wisdom to intensify mass campaigns in weaker health systems to bypass service provision bottlenecks. Mass campaigns do not inherently benefit or damage a health system, but frequent campaigns in weak health system contexts can impede service provision. We call for an additional burden of proof and active efforts to integrate mass campaigns into routine health services by harmonising implementation plans and service delivery in weak health system contexts.

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