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• absolute poverty A situation where the per capita income is equivalent to less than one international dollar per day.

• access to social support networks One of the aspects of the responsiveness of health systems whereby health care activities are integrated into community interaction in order to ensure patient welfare.

• action Any measure taken with some intention.

• actor Any person interacting with others in the health system.

• age-rating Technique for adjusting insurance premiums according to the age of the insured.

• annual growth rate Indicator used in population studies to assess average change in the size of a population from one year to the next.

• architecture Set of component elements of the health system and the structure of their relations

• autonomy One of the aspects of the responsiveness of health systems whereby one enjoys the freedom to decide for oneself on alternative treatment, testing and care options, including the decision to refuse treatment, if of sound mind.

• boundaries of the health system The outer limits within which the health system operates. More specifically, they include all activities whose primary intent is to improve health.

• boundary The outer limit of a concept.

• burden of disease The total significance of disease for society beyond the immediate cost of treatment. It is measured in years of life lost to ill health as the difference between total life expectancy and disability-adjusted life expectancy.

• choice of care provider One of the aspects of the responsiveness of health systems whereby those seeking care have a choice between and within health care units, including opportunities for gaining specialist care and second opinions.

• community rating Technique for adjusting insurance premiums according to family size or income.

• confidentiality One of the aspects of the responsiveness of health systems whereby privacy in the context of privileged communication (such as patient-doctor consultations) and medical records is safeguarded.

• consultation A technique of social interaction where opinions of all stakeholders are sought before a decision is made.

• consumer A buyer or user of goods or services in the economy.
  Someone who uses, is affected by, or who is entitled or compelled to use a health related service.

• coordination A technique of social interaction where various processes are considered simultaneously and their evolution arranged for the optimum benefit of the whole.

• created capital Physical infrastructure, buildings, machinery and equipment.

• defining goal The single most characteristic and specific reason for setting up a system, its raison d'être.

• dependency ratio Indicator used in population studies to measure the portion of the population which is economically dependent on active age group.
  It is calculated as the sum of 0-14 year olds and over 60 or 65 year olds, depending on the working age limit considered, divided by the number of people aged betwe15 and 59 or 64, respectively. For the purpose of the World Health Report, it is calculated as the sum of 0-14 year olds and over 65 year olds divided by the number of people aged betwe15 and 64.

• dignity The right of individuals to be treated with respect as persons in their own right.

• disability-adjusted life expectancy The number of healthy years of life that can be expected on average in a given population. It is generally calculated at birth, but estimates can also be prepared at other ages. Healthy life expectancy has the advantage of capturing all causes of disability across a population and relating them to life expectancy defined by mortality.

• disability-adjusted life years The number of healthy years of life lost due to premature death and disability.

• effectiveness A measure of the extent to which a specific intervention, procedure, regimen, or service, when deployed in the field in routine circumstances, does what it is intended to do for a specified population.

• efficiency The capacity to produce the maximum output for a given input.

• equality Principle by which all persons or things under consideration are treated in the same way.

• equality of child survival A composite index based on the distribution of child survival across countries and intended to provide a summary measure of countries' achievements in the distribution of health.

• equity Principle of being fair to all, with reference to a defined and recognized set of values.

• fair financing One of the three intrinsic goals of a health system whereby every member of society should pay the same share of their disposable income to cover their health costs.

• fairness The attitude of being just to all.

• fairness of financial contribution Index used to measure the distribution of the households' health financing contribution.

• fertility rate Indicator used in population studies to assess the average number of children women have in a given population.

• financing Function of a health system concerned with the mobilization, accumulation and allocation of money to cover the health needs of the people, individually and collectively, in the health system.

• function The special kind of activity proper to something, the mode of action by which it fulfils its purpose. Also in general application, esp. as contrasted with structure.

• goal A general objective towards which to strive.
  Unlike objectives and targets, goals are not constrained by time or existing resources, nor are they necessarily attainable but are rather an ultimate desired state towards which actions and resources are directed.

• governance The exercise of political, economic and administrative authority in the management of a country's affairs at all levels.
  It is a neutral concept comprising the complex mechanisms, processes, relationships and institutions through which citizens and groups articulate their interests, exercise their rights and obligations and mediate their differences. (UNDP)

• health A state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity.
  Health is a resource for everyday life, not the object of living. It is a positive concept emphasizing social and personal resources as well as physical capabilities.

• health care delivery One of the functions of the health system, which deals with the medical and therapeutic measures intended to preserve or improve the health condition of a patient.

• health indicator An indicator applicable to a health or health-related situation.

• health sector Part of the economy dealing with health-related issues in society.

• health system The people, institutions and resources, arranged together in accordance with established policies, to improve the health of the population they serve, while responding to people's legitimate expectations and protecting them against the cost of ill-health through a variety of activities whose primary intent is to improve health.
  Set of elements and their relations in a complex whole, designed to serve the health needs of the population.
  Health systems fulfil three main functions: health care delivery, fair treatment to all, and meeting non health expectations of the population. These functions are performed in the pursuit of three goals: health, responsiveness and fair financing.

• health system goal A general objective towards which the health system should strive.
  The World Health Report 2000 identifies three intrinsic goals of any health system:  
  health, which is also the defining goal
  responsiveness
  fair financing

• human capital Human skills and capabilities generated by investments in education and health.

• impact The total, direct and indirect, effects of a programme, service or institution on a health status and overall health and socio-economic development.

• indicator A variable with characteristics of quality, quantity and time used to measure, directly or indirectly, changes in a situation and to appreciate the progress made in addressing it. It also provides a basis for developing adequate plans for improvement.
  Variable susceptible of direct measurement that is assumed to be associated with a state that cannot be measured directly. Indicators are sometimes standardized by national or international authorities.
  Variable that helps to measure changes in a health situation directly or indirectly and to assess the extent to which the objectives and targets of a programme are being attained.

• inequality in health Differences in health across individuals in the population.

• information asymmetry The difference in the amount of information available to the various parties to a transaction which does not place them on equal footing to strike a deal.

• input A quantified amount of a resource put in a process.

• institution An organization or association, established for the promotion of some object, especially one of public or general utility (after OED)

• instrumental goal A goal whose pursuit is really a means to another end.

• intervention An activity or set of activities aimed at modifying a process, course of action or sequence of events, in order to change one or several of their characteristics such as performance or expected outcome.

• intrinsic goal A goal that is valued in and of itself.

• key informant Person chosen to answer a survey on the grounds of a better knowledge and understanding of the issues under consideration.

• life expectancy The number of year of life that can be expected on average in a given population

• mobilisation One of three subfunctions in the financing of health systems which aims at identifying and getting the money required to meet the health needs of the people, individually and collectively, in a given health system.

• national health accounts Information, usually in the form of indicators, a country may collect on its health expenditures. Indicators may include total health expenditure, public expenditure, private expenditure, out-of-pocket expenditure, tax-funded and other public expenditure, social security expenditure, public expenditure on health.

• natural capital The environment and natural resources.

• objective The end result a programme, a project or an institution seeks to achieve.
  A specific end point, condition or situation one is determined to achieve.

• outcome A change to a situation resulting from an action.

• out-of-pocket expenditure In public health, especially in relations to national health accounts, the sum of all out-of-pocket payments made by individuals.

• out-of-pocket payment Fee paid by the consumer of health services directly to the provider at the time of delivery.

• output The result of a process.

• patient A person in contact with the health system seeking attention for a health condition.

• performance The level of attainment of a goal in comparison to a given effort.

• policy formulation The development, expression and adoption of a policy.

• prepayment Fee paid by a potential consumer of health services in anticipation of services that may be required.

• process A continuous and regular action or succession of actions, taking place or being carried out in a definite manner, and leading to the accomplishment of some results.

• production An succession of actions designed to generate a product.

• professional accountability A conduct in accordance with good practice as recognized and endorsed by a professional society.

• professional self-regulation The enforcement of certain rules of conduct among its members by a professional community.

• prompt attention One of the aspects of the responsiveness of health systems whereby those needing care are able to access it speedily through conveniently located health care units, short waiting times and short waiting lists for consultation and treatment.

• quality of basic amenities One of the aspects of the responsiveness of health systems whereby non-health enhancing physical attributes of health care units, such as cleanliness of the facility, adequacy of furniture and quality of food, are paid attention to.

• regulatory capture A deviance in transaction practice by which one of the parties with vested interests in the deal exerts pressure on the regulators in order to obtain better conditions in the deal.

• responsiveness One of the three goals of the health system to meet people's legitimate non-health expectations about how the system treats them.

• risk pooling The practice of bringing several risks together for insurance purposes in order to balance the consequences of the realization of each individual risk.

• risk rating Technique for adjusting insurance premiums according to the relative risk insured.

• risk selection The practice of singling out or disaggregating a particular risk from a pool of insured risks.

• social group Any set of persons within society that differs from other sets due to demographic, economic or social characteristics such as age, sex, education level, race religion, income level, lifestyle, beliefs, etc.

• stakeholder Any party to a transaction which has particular interests in its outcome.

• stewardship A function of a government responsible for the welfare of the population, and concerned with the trust and legitimacy with which its activities are viewed by the citizenry.
  It requires vision, intelligence and influence, primarily by the health ministry, which must oversee and guide the working and the development of the nation's health actions on the government's behalf.
  As used in the WHR 2000 components of stewardship are:
  Health policy formulation: defining the vision and direction for the health system
  Regulation: setting fair rules of the game with a level playing field
  Intelligence: assessing performance and sharing information
  Stewardship is the overarching function that determines the success or failure of all other functions of the health system. It places the responsibility back on government and calls for the strengthening of ministries of health. However, it does not call for necessarily a hierarchical and controlling role of government but more of that of overseeing and steering of the health system. It calls for vision, setting of regulations and implementing them, and the capacity to assess and monitor performance over time. A strong stewardship should in fact permit a more efficient use of the private sector to meet the needs of the health system.

• system Set of elements interconnected in a complex whole fulfilling a function. Range of values an index may take depending on the actual values of each of the parameters integrated in it.
  For the purpose of the World Health Report 2000, indices have been calculated based on best available figures. Where data were missing, estimates have been used, in accordance with classical estimation techniques. The resulting index is subject to revision once actual data become available. Consequently, present values may have to be adjusted within the range indicated by the uncertainty interval.