Health systems: improving performance: round table1
AbstractWhen countries in the African Region attained independence about four decades ago, the main challenge was to build national health systems more oriented to solving the health problems faced then, such as the heavy burden of infectious diseases, lack of health care facilities and lack of human resources for health. Ensuring equal access to health care for all citizens was one of the goals set by the new governments. This principle was expressed explicitly or implicitly in the health policies adopted. The Alma Ata Declaration1 and the subsequent adoption of the Primary Health Care Strategy2 guided the achievement of the social goal of health for all. Several initiatives were launched thereafter to help countries achieve health for all. Examples are the Bamako Initiative3 and the Three-Phase African Health Development Scenario.4 3. During the last four decades, countries have spent a lot of resources to develop human resources, build health infrastructure and create legal instruments to support health. This has enabled countries to achieve some important results even though conflicts and socio-political instability, natural disasters, and poor economic performance have often compromised the achievements. 4. The countries, dissatisfied with the performance of national health systems, and as part of the economic adjustment programmes, embarked on health sector reforms. Although these were aimed at improving the performance of health systems, most approaches have been piecemeal, not holistic. This is partly reflected in the failures in implementation, especially at district level.
Regional Committe for Africa, 51. (2001). Health systems: improving performance: round table1. WHO. Regional Office for Africa. http://www.who.int/iris/handle/10665/95747