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Health Systems Strengthening Seminar Monitoring Health Systems Change/Health Reforms

Health Systems Strengthening Seminar Monitoring Health Systems Change/Health Reforms. Service provision Dr J. Gernay. Objective. To describe and analyze the strengths and weaknesses of the health system’s organization and structure, which serve as the foundation for Health services provision.

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Health Systems Strengthening Seminar Monitoring Health Systems Change/Health Reforms

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  1. Health Systems Strengthening SeminarMonitoring Health Systems Change/Health Reforms Service provision Dr J. Gernay

  2. Objective • To describe and analyze the strengths and weaknesses of the health system’s organization and structure, which serve as the foundation for Health services provision.

  3. Service provision • 1. Supply and demand of health services • 2. Human resources development • 3. Medicines and other health products • 4. equipment and technology • 5. Quality assurance

  4. SUPPLY Services designed to promote , prevent, recover,& rehabilitate the health of a target population (individual and collective level) ( facilities, complexity level, bed count...)Table 17 DEMAND Explicit request for health services Utilization expresses the demand that was satisfied with regard to a target population in a given period. (use of health services at PHC and SHC level…)Table 16 1. Supply and demand for health services

  5. 1. Supply and demand for health services • Identification of gaps in health care • Determination of problem areas • Recommendations for policies , plans and programmes

  6. 2. Human Resources Development • 1. Training • 2. HR Management and working conditions • 3. Supply and distribution (labor market) • 4. Governance and sectoral conflict

  7. How many HR Health/pop? How fast are they produced? Adapted to the population needs? # schools? Specialists vs. generalists? Frequency of review of curricula? 2. Human Resources DevelopmentTRAINING

  8. Reform processes result in: New institutional organization (self managed hospitals) New labor relations ( outsourcing) -----new : contracts, changes in career, job security, incentives Research? Employment distribution public/private/ geographically? Income : qualification Reclassification? Outsourcing? 2. Human Resources DevelopmentHR MANAGEMENT

  9. Quantity by: Profession Sex Public/private sector Geographical region Table 18,19 Professional migration? 2. Human Resources DevelopmentSUPPLY & DISTRIBUTION OF HR

  10. Organization of health workers ( associations, unions) Power restructuring with decentralization/ unequal implementation ------- Resistance to change / conflicts/ slow implementation Capacity for conflict management? Policy consensus? Participatory management? 2. Human Resources DevelopmentGOVERNANCE AND CONFLICT IN HEALTH SECTOR

  11. High health expenditures Economic importance of sectors involved in research, development, production, distribution& dispensing ? Roles of private/ public sector Essential medicines observatory, policy, regulatory processes, national list (VEN)? Treatment protocols? Obligatory pharmacist presence? Table 20 3. Medicines & other Health products

  12. 4. Equipment & technology • Table 21 availability of equipment • % defective/ out of use • % of budget for maintenance?

  13. 5. Quality assurance • Basic health care standards? • QA programmes? • Accreditation criteria ,procedure & entity? • Complaint mechanisms? • Measurement of H. Services performance vs. established Quality standards? • Standards: HR, $, inputs, technology, monitoring frequency?

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