Using the World Health Organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities

Abstract

BackgroundAcknowledging the health system strengthening agenda, the World Health Organization (WHO) has formulated a health systems framework that describes health systems in terms of six building blocks. This study aimed to determine the current status of the six WHO health system building blocks in public healthcare facilities in Ethiopia.MethodsA quantitative, cross-sectional study was conducted in five public hospitals in central Ethiopia which were in a post-reform period. A self-administered, structured questionnaire which covered the WHO’s six health system building blocks was used to collect data on healthcare professionals who consented. Data was analyzed using IBM SPSS version 20.ResultsThe overall performance of the public hospitals was 60% when weighed against the WHO building blocks which, in this procedure, needed a minimum of 80% score. For each building block, performance scores were: information 53%, health workforce 55%, medical products and technologies 58%, leadership and governance 61%, healthcare financing 62%, and service delivery 69%. There existed a significant difference in performance among the hospitals (p < .001).ConclusionThe study proved that the WHO’s health system building blocks are useful for assessing the process of strengthening health systems in Ethiopia. The six blocks allow identifying different improvement opportunities in each one of the hospitals. There was no contradiction between the indicators of the WHO building blocks and the health sustainable development goal (SDG) objectives. However, such SDG objectives should not be a substitute for strategies to strengthen health systems.

‘I think we are going to leave these cases’. Obstacles to surgery in rural Malawi: a qualitative study of provider perspectives

“…Thirdly, our research confirms findings from previous studies about the negative effect of structural barriers, such as shortages of surgical essentials, on the provision of surgical care in low and middle income countries . Our study suggests that by improving skills, confidence, attitudes and motivation of local surgical teams, supportive supervision can contribute to mitigating some of the structural barriers at rural district hospitals.…”

“…It is part of the essential package of services needed to achieve universal health coverage (UHC) . As such it is an indicator of how close or far a country is from achieving UHC ; and, if high coverage can be achieved, can help drive the delivery of comprehensive UHC . Yet, despite consensus that access to surgical services on a global scale is required (WHA Resolution 68.15) , 5 billion people do not have access to safe, affordable surgical and anaesthesia care when needed .…”

Exploring Current Iran’s Primary Healthcare System: Challenges and Solutions

“…Furthermore, the studies con rmed that the PHC in Iran at a local-organizational structure faces some problems in responding to new population needs, which gradually weaken the system [21]. The PHC in Iran has some challenges and weaknesses that oblige structural reforms [22,23]. Malekafzali argued that we are concerned about the diminished monitoring of PHC due to the high employment of the head of the university and his deputies [11].…”

“…Regarding the workforce employed at the PHC, the results of this study indicated that paying for the PHC personnel is not related to the way services are provided. Some studies suggested that there are different payment models in Iranian health system and the current payment system should be improved [22,23,28] The payment system to the service provider in PHC Iran has not been favorable and it is not an incentive to improve performance, quality and performance for them [21]. In addition, the studies con rmed that ine ciencies in the public governmental system and administrative costs were accompanied by a lack of PHC resources [25].…”

“…Some studies indicated that there is an ever-increasing urgency in global health to increase the use of digital health interventions beyond pilot projects [29]. The effectiveness of health interventions is based on new communication technologies [22]. Strengthening the innovations contributing to the success and sustainability of health systems is signi cant [23].…”