Health Systems in Action: an eHandbook for Leaders and Managers

1. AChieViNG ReSULtS BY StReNGtheNiNG heALth SYSteMS 1:6
FIGURe 1. Framework for People-Centered Health Systems Strengthening
Managers skilled and
motivated to lead and
manage health systems
Clients
(including family
and community)
Government
(including MOH)
Finance Services HR
Leading and
managing
to achieve
results
HMIS Medicines L&G
Feedback
Improved system
performance
Providers
(including
private sector)
Increased
access to
and use
of quality
health
services
RESULTS
Better
health
outcomes
Key: hR: human Resources; hMiS: health management information systems; L&G: leadership and governance.
Strengthening shown in Figure 1. This figure illustrates a systematic pathway to better
health outcomes with the capacity to lead and manage at the center of the framework. The
six key health system building blocks in the outer circle are needed to support the effective
use of resources and improve performance in service delivery. They are the focus of the
interaction among critical stakeholders: government, health care providers, clients, and
communities. All the parts of this model must work together to support the stakeholders
and achieve the results: increased access and use of services and, ultimately, better health
outcomes.
It is so obvious that people run a health system, whether in the public, nonprofit, or forprofit
sectors, we sometimes overlook this critical fact. Much attention is devoted to the
process aspect of systems. Often ignored are those who develop or improve processes
and procedures to foster the smooth flow of information, money, medicines, and people
within the overall health system. The Framework for People-Centered Health Systems
Strengthening attempts to remedy this imbalance. It provides a way to think about this
critical component of system performance and, ultimately, of improved health outcomes.
Who are the people in the “people-centered” framework? Box 1 shows them as those who
develop the systems, use the systems to do their work, and benefit from strong systems.
As the manager of a health program or health services, you can help strengthen health
systems by applying this systematic pathway to your work. It is critical to focus on the
people who need the skills and support to integrate and use the six building blocks and
management systems to deliver high-quality health care.
Your professional role might be specialized. You might focus on gathering information,
combining it with information from others, and using it to make sure there is an uninterrupted
supply of medicines, vaccines, and contraceptives. If you work at headquarters,
www.msh.org/resource-center/health-systems-in-action.cfm HeAltH SySteMS In ACtIon