Health systems

Health Systems Strengthening Glossary


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Paris Declaration on Aid Effectiveness: an international agreement to which over one hundred ministers, heads of agencies and other senior officials adhered and committed their countries and organizations to continue to increase efforts in ownership, harmonization, alignment, mutual accountability and managing aid for development results with a set of monitorable actions and indicators, endorsed on March 2, 2005 at the Second High Level Forum on Aid Effectiveness. 1

People-centred care: care that is focused and organized around the health needs and expectations of people and communities rather than on diseases. People-centred care extends the concept of patient-centred care to individuals, families, communities and society. Whereas patient-centred care is commonly understood as focusing on the individual seeking care—the patient—people-centred care encompasses these clinical encounters and also includes attention to the health of people in their communities and their crucial role in shaping health policy and health services. 2

Performance monitoring: the continuous process of collecting and analysing data to compare how well a project, program, or policy is being implemented against expected results. 3

Performance-based payment (PBP), performance-based funding: Payment or funding conditional upon taking a measurable action or achieving a predetermined performance target. May refer to transfer of funds by donors to recipient countries, or to payment of providers or provider organizations for reaching service targets. 4

Personal Health Services: Health services targeted at the individual. These include, among others, health promotion, timely disease prevention, diagnosis and treatment, rehabilitation, palliative care, acute care and long-term care services. 5

Pledge: A binding promise or agreement to give a grant or loan. 6

Policy dialogue: (i) the process of policy making or policy formation, i.e. of recognition of social demand, transformation into political demand and, eventually, into formulation of a policy statement that provides guidance to subsequent decisions about technical implementation (WHO 1982); and/or, (ii) the social debate and interaction between stakeholders that leads to translation of policy into strategies and plans.

Primary care: often used interchangeably with first level of care. (i) the part of a health services system that assures person focused care over time to a defined population, accessibility to facilitate receipt of care when it is first needed, comprehensiveness of care in the sense that only rare or unusual manifestations of ill health are referred elsewhere, and coordination of care such that all facets of care (wherever received) are integrated. Quality features of primary care include effectiveness, safety, people-centredness, comprehensiveness, continuity and integration. 7 (ii) the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. 8

Primary Health Care Based Health System: health system organized and operated so as to make the right to the highest attainable level of health the main goal while maximizing the equity and solidarity. A PHC-based health system is composed of a core set of structural and functional elements that guarantee universal coverage and access to services that are acceptable to the population and that are equity-enhancing. It provides comprehensive, integrated and appropriate care over time, emphasizes prevention, promotion, and first contact primary care as well as intersectoral actions to address other determinants of health and equity. 9

Primary Health Care reforms: policy reforms needed to move towards health for all: moving towards universal coverage in order to contribute to health equity, social justice and the end of exclusion; shifting service delivery to people-centred primary care, to make health services more socially relevant and responsive to the changing world, while producing better outcomes; ensuring health in all policies to secure healthier communities by integrating public health actions with primary care and by pursuing healthy public policies across sectors; promoting inclusive leadership and governance, to replace disproportionate reliance on command and control or on laissez-faire disengagement of the state by participatory, negotiation based leadership. 10

Primary Health Care values: he values that underpin primary health care, including solidarity, social justice, the right to better health for all, and participation. 11

Primary Health Care: a health reform movement launched at Alma Ata in 1978 to move towards health for all. (i) 1978: Essential health care based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. It forms an integral part of both the country’s health system, of which it is the central function and the main focus and of the overall social and economic development of the community. 12 (ii) 1980s The set of activities outlined in the Declaration of Alma-Ata: education concerning prevailing health problems and the methods of preventing and controlling them; promotion of food supply and proper nutrition; an adequate supply of safe water and basic sanitation; maternal and child health care, including family planning; immunization against the major infectious diseases; prevention and control of locally endemic diseases; appropriate treatment of common diseases and injuries; and provision of essential drugs. (iii) 1990s: a level of care, that is the point of entry to the health services system (see: primary care). (iv) 2008: a set of policy orientations and reforms needed to move towards health for all: moving towards universal coverage; shifting service delivery to people-centred primary care; ensuring health in all policies; promoting inclusive leadership and governance. 13 (See Primary Health Care reforms)

Priority setting: the identification, balancing and ranking of priorities by stakeholders.

Programme aid: a range of interventions including budget support, debt relief and balance of payments support to support a higher level of expenditure. Funds are accounted for against import spending (balance of payments) or against domestic public expenditure (government budget). 14

Programming: the stage of the national health planning cycle in which the National Health Policy/Strategy/Plan (and in some cases its Medium Term Expenditure Framework), is translated into annual operational plans.

Project aid: aid flows earmarked to specific activities or a discrete set of activities for which coherent objectives and outputs and the inputs required to achieve them are defined." 15

Public Health Services: health services targeted at the population as a whole. These include, among others, health situation analysis, health surveillance, health promotion, prevention services, infectious disease control, environmental protection and sanitation, disaster preparedness and response, and occupational health. 16

Public Health: an organized effort by society, primarily through its public institutions, to improve, promote, protect and restore the health of the population through collective action. It includes services such as health situation analysis, health surveillance, health promotion, prevention, infectious disease control, environmental protection and sanitation, disaster and health emergency preparedness and response, and occupational health, among others. 17

Purchasing power parity(PPP): conversion of economic figures to International Dollars, which inside each country should have the same purchasing power of one US$ in the United States. 18

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References

  • See: http://www.oecd.org/document/18/0,3343,en_2649_3236398_35401554_1_1_1_1,00.html
  • People centred care in low- and middle-income countries - meeting report. Geneva, World Health Organization, 2010.
  • Aid Management Guidelines [online glossary] Ministry of Foreign Affairs of Denmark -http://amg.um.dk/en/servicemenu/Glossary/Glossary.htm
  • Eichler R. Can ‘‘Pay-for-Performance’’ increase utilization by the poor and improve the quality of health services. Washington, D.C., Center for Global Development, 2006. Available at: http://www.cgdev.org/doc/ghprn/PBI%20Background%20Paper.pdf
  • Análisis del sector salud, una herramienta para viabilizar la formulación de políticas, lineamientos metodológicos. Edición especial No. 9. Washington, D.C., La Organización Panamericana de la Salud, 2006.
  • Merriam-Webster’s online dictionary. http://www.merriam-webster.com/
  • See: Starfield B. Basic concepts in population health and health care. Journal of Epidemiology and Community Health 2001;55:452-454. doi:10.1136/jech.55.7.452. and The world health report 2008: primary health care – now more than ever. Geneva, World Health Organization, 2008.
  • Institute of Medicine. Primary care: America’s health in a new era. Washington, D.C., National Academy Press, 1996
  • La renovación de la atención primaria de salud en las Américas: documento de posición de la OPS/OMS. Washington, D.C., Organización Panamericana de la Salud, 2007.
  • The world health report 2008: primary health care - now more than ever. Geneva, World Health Organization, 2008
  • World Health Organization and UNICEF. Primary Health Care: Report of the International Conference on Primary Health Care. Alma Ata, USSR, 6-12 September 1978. Geneva, World Health Organization. Available at http://whqlibdoc.who.int/publications/9241800011.pdf
  • See: Declaration of Alma-Ata. Available at http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf
  • The world health report 2008: primary health care - now more than ever. Geneva, World Health Organization, 2008.
  • DFID Workshop Handbook on Direct Budget Support and SWAps. London, UK Department for International Development, 2002.
  • Foster M, Leavy J. The choice of financial aid instruments. London, Centre for Aid and Public Expenditure, ODI (Working Paper 158), 2001.
  • La salud pública en las Américas: nuevos conceptos, análisis del desempeño y bases para la acción. Publicación científica y técnica No. 589. Washington, D.C., Organización Panamericana de la Salud, 2002.
  • La salud pública en las Américas: nuevos conceptos, análisis del desempeño y bases para la acción. Publicación científica y técnica No. 589. Washington, D.C., Organización Panamericana de la Salud, 2002.
  • WHO, 2003
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