DBL - under core funding from Danish International Development Agency (Danida) 2013
WHY HAVE HEALTH SYSTEMS WHEN EFFECTIVE INTERVENTIONS ARE KNOWN?
Case: A teenage mother lives in a poor sub-Saharan village next to a big lake. The area is
known to have malaria transmission all year around, and surveys in nearby villages
have shown a high prevalence of intestinal helminthiasis and schistosomiasis. The
HIV prevalence in similar rural settings is about 10% in her age group.
She has been losing weight over the last months and now her one-year-old child
feels hot and is not eating well. She has tried herbal remedies for both of them for a
week but without effect. The family permits her to travel with her child quite some
distance to a fairly run down health centre ---- (Cont. with her meeting services, but going home unserved)
WHAT ARE HEALTH SYSTEMS AND HEALTH SYSTEMS RESEARCH?
Health systems include all organisations that influence health, whether they provide
health services, address broader conditions for improved health or represent the users
and communities that strive for better health. However health systems simply lack the capacity to measure or understand their own weaknesses and constraints. This effectively leaves policy-makers.without scientifically sound ideas of what they can and should actually strengthen within ever limited resources. Within such unmapped and misunderstood systems, interventions – even the very simplest – often fail to achieve their goals and no recommeded improvements work similarly in the vast array of social and other local contextual factors. Local, fair and accountable priority setting processes are neccessary to make the best of ever shifting national level strategies and priorities. An approach is described, which can assist in the involvement of providers, health workers and communities in reaching consensus on needed, demanded and affordable health action in each setting (e.g. district).