Health systems strengthening: improving district health service delivery and community ownership and participation
Abstract1. The World Health Organization defines a health system as all organizations, people and actions whose primary intent is to promote, restore and maintain health. It has six interrelated building blocks, namely, service delivery; health workforce; information; medical products, vaccines and technologies including infrastructure; financing; and leadership or governance. Improvements in service delivery require simultaneous improvements in the other building blocks at all levels of implementation including the district. 2. A district is defined as “a clearly defined administrative area covering a population at which some form of local government or administration takes over many responsibilities from central government departments”.2 It translates central government aspirations, policies, strategic directions and road maps into district-level action and forges a mutually accountable partnership between people and government. A health district is the part of local government that takes over the responsibilities of the central ministry of health. It is large enough to justify the investment and management costs and small enough to be familiar with the relevant demographic and socioeconomic factors. It is normally equal to the administrative district and serves approximately 50 000 to 300 000 people.3 3. The effectiveness of the organization and management of service delivery in the district depends, among others, on the competence and number of members of the district health management team as well as relevant management teams in health centres, health posts and communities. These teams coordinate the planning, implementation, monitoring and evaluation of health service delivery.
Regional Committee for Africa, 60. (2011). Health systems strengthening: improving district health service delivery and community ownership and participation. https://apps.who.int/iris/handle/10665/1683