2016;388(10053):181350. A quantitative, cross-sectional study was carried out to analyze the status of the Six WHO health system building blocks in public hospitals in central Ethiopia, thus Addis Ababa. 2014;10:64. We also support governments withresearchthat monitors and improves the effectiveness of health policies. The bureau administers six public hospitals which deliver advanced preventive and curative health services, from which all that have been implementing the BPR healthcare reform since its inception in 2009 (n=5) were purposively selected to maximize the scope of the study thereby ensure external validity. Without quality health care and services, children are more susceptible to illness, environmental hazards and the devastating effects of humanitarian emergencies. 2015;47(4):28391. In addition, governments must reduce barriers to health innovation and actively support African researchers and centres involved in the sciences. Assessment of client satisfaction with health service deliveries at Jimma university teaching hospital. UNICEF works with governments to improve the quality of newborn, child, adolescent and maternal health care - especially at the community level. The 2016 transition in global health from Millennium Development Goals (MDGs) to Sustainable Development Goals (SDGs) is a remarkable move for resource-limited countries that have been struggling to improve the quality of healthcare at the ground [1,2,3,4]. BOX 392, South Africa, You can also search for this author in Prioritising sustainable investments in line with WHOs Health System Pillars offers the potential to reorganise health systems in a way that maximises impact across the entire health landscape in support of addressing COVID-19 and other health issues. WHO defined HSS as "any array of initiatives that improves one or more of the functions of the health systems and that leads to better health through improvements in access, coverage, quality or efficiency". Each of the five responses had a numerical value (15), in which the highest two scoring answers (4 and 5) were taken as positive outcomes while the rest three responses were considered as negative outcomes. This research project has been supported by the University of South Africa. Mann C, Ng C, Akseer N, Bhutta ZA, Borghi J, Colbourn T, et al. Similarly, information communication and exchange methods, which are active catalysts in the broad-based health development, were stagnated, thus need improvements. Health Policy Plan. 2017;15:10. Such constraints need practicable health information strategies coupled with monitoring system. The study set out to the existing information system in terms of the WHO building block and found that information is limited in opportunity and scope. On-time access to services and availability of services in a mode of communication suitable to patients both scored 69%. Systems thinking is an approach with a long history that has been applied in different fields, such as computer science, management, and ecology. Priority setting for health system strengthening in low income 2010. In the same sense, there have been many guidelines that the FMoH and its partner organizations developed and shared for bench-level use. Service delivery had some fairly gains. Haiti Earthquake Recovery: strengthening health systems, Health systems strengthening | IMA World Health. As the questions were grouped under the six building blocks, a scale score was computed as the mean of the scale item scores, while the median score was employed to measure central tendency among individual questions. To improve health resilience in fragile settings, it strengthens health systems to expand coverage and use of quality health services; assists countries in adapting evidence-based policies, guidelines, and practices at national and subnational levels; supports and strengthens local efforts to collect and analyze data and ensure evidence informs interventions; increases public-private partnershipsand expands partnerships between health and non-health organizations, educational institutions, and corporate and philanthropic organizations to diffuse learning, leverage resources, and scale efforts to achieve better outcomes. 2016;1:e000003. This study aimed to determine the current status of the six WHO health system building blocks in public healthcare facilities in Ethiopia. Evidences revealed that the framework helps to assess in-country healthcare performances [17], interactions between health reforms and country health systems [18], implications of health sector reforms [19], and the status of health facilities [20] and specific health problems [21]. Arch Public Health 75, 50 (2017). BMC Health Serv Res. The study witnessed that there were major issues which may affect the status of the six WHO building blocks in public hospitals. Data for development in health: a case study and monitoring framework from Kazakhstan. Addis Ababa, Ethiopia: FMoH; 2015. The study proved that the WHOs health system building blocks are useful for assessing the process of strengthening health systems in Ethiopia. : +41 22 791 3791Fax: +41 22 791 4817Email:[emailprotected]. With significant contributions from global partners, the government of Ethiopia tailored to meet many of the global health indicators. A national system for monitoring the performance of hospitals in Ethiopia. Busse H, Aboneh EA, Tefera G. Learning from developing countries in strengthening health systems: an evaluation of personal and professional impact among global health volunteers at Addis Ababa University's Tikur Anbessa Specialized Hospital (Ethiopia). Measuring the health systems impact of disease control programmes: a critical reflection on the WHO building blocks framework. Fisher JR, Cabral de Mello M. Using the World Health Organization's 4SFramework to Strengthen National Strategies, Policies and Services to Address Mental Health Problems in Adolescents in Resource-Constrained Settings. Newcastle, United Kingdom. Access principle 3: strengthening healthcare systems Until this point, use of systems thinking in HPSR had been practised predominantly in high-income countries. Stretched objectives were synthesized and sub processes that form the core process identified. The WHO position paper comes at a crucial time to provide leaders and policymakers with recommendations on positioning health within the wider discussions on socioeconomic recovery and transformation. Glob health action. Systems thinking in practice: the current status of the six WHO building blocks for health system strengthening in three BHOMA intervention districts of Zambia: a baseline qualitative study. The author learned from the healthcare professionals that there is a loosen linkage between financial mobilization and evidence-based planning. An analytical framework used by WHO to describe health systems, disaggregating them into 6 core components: Leadership and governance. Systems thinking takes into consideration that action or changes in one aspect of a health system is likely to affect what results in another. Less than 10% of the continents 1.2 billion people are vaccinated, compared with at least 50% of the rest of the world. to rebuild their health systems sustainably, more equitably and closer to communities. The findings revealed that the overall performance of public hospitals which were in a post-reform phase was lesser when weighed against the WHOs six health system building blocks. The 2016 transition in global health from Millennium Development Goals (MDGs) to Sustainable Development Goals (SDGs) is a remarkable move for resource-limited countries that have been struggling to improve the quality of healthcare at the ground [14]. Good service deliveries are those which deliver effective, safe, quality personal and non-personal health interventions to those that need them, when and where needed, with minimum waste of resources. South Africa, for example, through the African Union (AU), received funding from the US International Development Finance Corporation, and its European partners, to boost its manufacturing capacity. Table Table11 summarizes the status of the WHO six building blocks in the study hospitals. Overall, there is a need for further progress in all the six WHO health system building blocks. From this budget, public hospitals need to secure a significant share to enhance their capacity and be equipped with innovative technologies. 5 This is a broad definition, which can potentially include most programmatic interventions, and therefore lacks specificity. The 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. PDF HEALTH SYSTEMS STRENGTHENING - World Health Organization This needs keener interest of the hospitals administrations to probe on the governance constraints and take possible interventions to attain the intended WHO governance/leadership needs among others. Studies indicate the WHO health system framework is instrumental in strengthening the overall health system and uses as catalyst for achieving global health targets such as the SDGs. Accessibility There was a significant difference in healthcare performance between at least two hospitals (2=571.902, p<.001). GBD 2015 SDG Collaborators. One way of ensuring this happens is putting greater energy and resources into public health institutions. International Health. a pile Jack Rice couldn't jump over. The hospitals governances did not pursue staff loyalty to effectively use their time to maximize the hospitals capacity and sustainability. For instance, the country has successfully achieved six of the eight MDGs, including MDG Goal 4 and other targets for HIV/AIDs, malaria, tuberculosis and other diseases, while MDG 5 (improve maternal health) is an area the country was off-track [22]. The public hospitals scored less for each WHO building block, which includes information, health workforce, medical products/technologies, leadership/governance, healthcare financing, and service delivery. The study was conducted between January and June 2015. Improving health care financing in Ethiopia: an evidence brief for policy. approach to building and rebuilding health systems that serve the needs of the population, before, during and after public health emergencies. The study proved that the WHOs six health system building blocks are useful for assessing the process of strengthening health systems in Ethiopia. 2014;13(24):18. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The healthcare financing capacity, in relation to healthcare goods and services, indicates that mandatory steps still remain. Health systems frameworks in their political context: framing divergent agendas. Strengthening health systems in low-income countries by enhancing organizational capacities and improving institutions. PDF The Regional Six-point Strategy for Health Systems Strengthening based Studies indicate the WHO health system framework is instrumental in strengthening the overall health system and uses as catalyst for achieving global health targets such as the SDGs. On average, ASSP exceeded program targets by six percentdespite ongoing conflict affectingthe projects implementation area. The average score for service delivery was 69%, which was yet lower than the perceived 80% and above score. These indicate that the healthcare financing gaps identified in this study need to restructure. The dataset supporting the conclusions of this article is included within the article. WHO's 7 policy recommendations on building resilient health systems The Addis Ababa Health Bureau has been implementing the healthcare reform in public healthcare sector that it owned. Six Pillars of Health Systems Strengthening - Infogram a pillar of society, etc. Article The target group was all healthcare professionals in the public hospitals (n=1681) which included medical doctors, nurses, laboratory professionals, pharmacists, dentists, health officers, and sanitarians. The study set out to the existing information system in terms of the WHO building block and found that information is limited in opportunity and scope. UNICEF helps governments to establish packages of care, incentive and compensation structures for health workers, supervision and supply chain models. However, such SDG objectives should not be a substitute for strategies to strengthen health systems. Health Sector Transformation Plan (HSTP): 2015/162019/20. In coordination with partners, UNICEF supports governments to develop effective policies that strengthen health systems for children, especially for the most vulnerable. 2. The reform has been progressively implemented through a series of training sessions for managers and technicians at all levels followed by changes in staff deployment, specific job assignments and the recruitment of new staff. For instance, the country has successfully achieved six of the eight MDGs, including MDG Goal 4 and other targets for HIV/AIDs, malaria, tuberculosis and other diseases, while MDG 5 (improve maternal health) is an area the country was off-track [22]. But inequities among and within countries persist. There is a critical need to increase Africas capacity to produce vaccines. Hence, expanding the sources of the study data set to capture more inclusive information that could be obtained from patients or the existing hospital data was necessary. A quantitative, cross-sectional study was conducted in five public hospitals in central Ethiopia which were in a post-reform period. PubMed Central It is a 2021 update of a health systems strengthening evidence review originally undertaken for the office in 2019 (see . Monitoring and evaluation system of the hospitals was viewed as a fairly practice when compared with other responses in this section. This needs keener interest of the hospitals administrations to probe on the governance constraints and take possible interventions to attain the intended WHO governance/leadership needs among others. In 2009, the Alliance published its third flagship report, Systems Thinking for Health Systems Strengthening. Ethiopian Journal of Health Science. Strengthening health systems in low-income countries by enhancing organizational capacities and improving institutions. BMC Public Health. Social Medicine in Practice. 2013;88(3):54751. The study proved that the WHOs health system building blocks are useful for assessing the process of strengthening health systems in Ethiopia. Int J Ment Health Syst. The study witnessed that there were major issues which may affect the status of the six WHO building blocks in public hospitals. Ethiopia BMC Nursing. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the sustainable development goals. UNICEF works with governments and partners to strengthen supply chains crucial to the health sector. Cambridge Scholars Publishing 2010. a pillar of society. Now a new health order is required to provide the networking and infrastructure for them to apply their talents for maximum impact. These include: hospital and ambulatory care health-related research, production of vaccines, drugs, reagents, and diagnostic kits. a pile. When autocomplete results are available use up and down arrows to review and enter to select. The study captures major claims on availability of staff restrooms (47%). As households in rural part of Ethiopia are included in public health insurance schemes [39], the Ethiopian government could shift existing budgets for strengthening health system at public hospitals. TM analysed and interpreted data, wrote the first draft, critically revised it for important intellectual content and approved the final version of the manuscript for publication. Introduction. Article By using innovative performance-based contracting, IMA incentivized the government to ensure RDTs and ACT were available at all health facilities, and that they were used appropriately to diagnose and treat malaria. Unlike other health system strengthening strategies which are disease-specific [13] or narrow [14,15,16], the WHOs health system framework intends to improve the overall health in a responsive, financially fair and most efficient way [11]. 2016;9:32443. The majority of participants (195, 48%) were in the age ranging from 30 to 39, while very few (26, 6.4%) were in the age ranging from 50 to 59. The 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. Pillars of the Health System. International Journal of Economics, Finance and Management Sciences. COVID-19 has hit vulnerable populations particularly hard and exacerbated preexisting inequalities even further. Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. PDF Chapter 7 Pillars of the Health System - DCP3 Bundhamcharoen K, Limwattananon S, Kusreesakul K, Tangcharoensathien V. Contributions of national and global health estimates to monitoring health-related sustainable development goals. Lack of job satisfaction, motivation, convenient infrastructure, timely performance feedback, and qualified staff were major gaps identified in the public hospitals. 2012;12:774. Privacy Promoting the use of systems thinking has remained a key pillar of Alliance efforts. Ensuring greater donor and national-level investments in this area of work and supporting decision-makers to apply the approach at the government level will be key priorities. The average score for health workforce was 55%, which was much lower than the 80% score perceived for the WHOs health system framework for health workforce. The majority of participants (195, 48%) were in the age ranging from 30 to 39, while very few (26, 6.4%) were in the age ranging from 50 to 59. Health information systems. However, additional specific strategies which target public hospitals need to be formulated to address finance related gaps identified in the study. Access principle 3: strengthening healthcare systems A medicine is only as good as the system that delivers it. The author learned from the healthcare professionals that there is a loosen linkage between financial mobilization and evidence-based planning. Adds Ababa City Government Health Bureau (AAHB). The impetus for medical technologies and practices had gaps when scaled against the intended WHO requirements. As the questions were grouped under the six building blocks, a scale score was computed as the mean of the scale item scores, while the median score was employed to measure central tendency among individual questions. district) and community levels, providing tailored assistanceand capacitystrengtheningthatboostsengagement, capability and investment at all levels ofa countryshealth system. PubMed Central The various MDG targets for health were instrumental in shaping healthcare outcomes; with a significant number of resource-limited countries able to meet the targets [5, 6]. Healthcare professionals in the hospitals recognized that access to internet is limited (38%) to hospital staff. In line with the WHO health system building blocks, the overall health system performance of public hospitals in central Ethiopia was 60%. 1. FMOH Addis Ababa; Ethiopia http://www.nationalplanningcycles.org/sites/default/files/country_docs/Ethiopia/ethiopia_hsdp_iv_final_draft_2010_-2015.pdf, Sturdy GR. Moon S. WHO's role in the global health system: what can be learned from global R&D debates? Inclusion in an NLM database does not imply endorsement of, or agreement with, Manyazewal, T. Using the World Health Organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities. Am J Trop Med Hyg. The status of the WHOs six building blocks at public health facilities would configure the health system and its outcomes in national as well as global needs. volume75, Articlenumber:50 (2017) Definition: Health System system is an arrangement of parts and their interconnections that come together for a purpose. This finding is in support of previous studies conducted in Ethiopia at different times and with different target populations [40,41,42,43]. 2013;13:291. Frenk J. The funds from the sales of medicine replenish the credit line and go towards building a facilitys financial reserves for future medicine procurement. The policy options that the FMoH proposed to address challenges in healthcare financing are health insurance and social health insurance [38]. To help children survive and thrive, health systems need sufficient fundingto be sustainable, resilient and inclusive. Keeping this up-front, this study intends to determine the current status of the WHOs six health system building blocks in public hospitals in central Ethiopia. responsive and financially fair, while treating people respectably. There are pharmaceutical companies in 40 of Africas 54 countries. This study is with some limitations. A well-functioning health system ensures equitable access to essential medical products, vaccines and technologies of assured quality, safety, efficacy and cost-effectiveness, with scientifically sound and cost-effective use. In the HSTP, four pillars of excellence are believed to help the sector attain its mission and vision: health service delivery, quality improvement and assurance, leadership and governance, and health system capacity. Systems thinking is a philosophical frame, and it can also be considered a method with its own tools. Measuring the health systems impact of disease control programmes: a critical reflection on the WHO building blocks framework. 2015;93(10):71926. Everybody's business - strengthening health systems to improve health outcomes: WHO's framework for action. Every child has the right to survive and thrive. The aim is to use pan-African and global partnerships to scale-up vaccine manufacturing in Africa. Table 1 summarizes the status of the WHO six building blocks in the study hospitals. Similarly, it is worthy that these countries have given increased attention to the current SDGs for health. The target group was all healthcare professionals in the public hospitals (n=1681) which included medical doctors, nurses, laboratory professionals, pharmacists, dentists, health officers, and sanitarians. Kebede A, Gebreslassie M, Yitayal M. Willingness to pay for community based health insurance among households in the rural community of Fogera District, north West Ethiopia. In this leadership/governance category, a relatively highest score (65%) was in the use of resources, while the least score (58%) was in the use of staff working hours. Ethiopian Journal of Health Science. Copyright 20102023, The Conversation Media Group Ltd, received funding from the US International Development Finance Corporation, Partnerships for African Vaccine Manufacturing, Research Fellow: Ecosystems in the Global Biodiversity Framework. Federal Democratic Republic of Ethiopia Ministry of Health (FMoH). Impact of Health Systems Strengthening on Health | HFG Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the sustainable development goals. The cost which was estimated for implementing the HSTP in the year 2015/162019/20 is $177,723,169, where the highest share goes to human resource and infrastructure [22]. Wispelway BP. Yami A, Hamza L, Hassen A, Jira C, Sudhakar M. Job satisfaction and its determinants among health workers in Jimma university specialized hospital, southwest Ethiopia. 2016;6(9):e012582. The author would like to thank Prof. MC Matlakala, Prof. MJ Oosthuizen, and Dr. Shewangizaw Getahun for their expert guidance. Building on the lessons learned in the MDGs and considering the current socioeconomic landscape, the Government of Ethiopia is developing and implementing its Health Sector Transformation Plan (HSTP) a five-year (20152020) national health sector strategic plan and the first phase in the Envisioning Ethiopias Path towards Universal Health Coverage through Strengthening Primary Healthcare [22]. It expands access to the most vulnerable children and adolescents, and integrates services in health, nutrition, early childhood development, HIV and AIDS, and water, sanitation and hygiene. http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, http://www.who.int/healthsystems/strategy/everybodys_business.pdf, http://globalfinancingfacility.org/sites/gff_new/files/documents/HSTP%20Ethiopia.pdf, http://www.nationalplanningcycles.org/sites/default/files/country_docs/Ethiopia/ethiopia_hsdp_iv_final_draft_2010_-2015.pdf, http://www.cambridgescholars.com/download/sample/58104, New organizational practices and policies, Capacity to assemble and manage resources, Efficient and effective health care financing system, Linkage of financial mobilization with evidence-based plan, The required financial resources to insure sustainability, Reduced wastage and enhanced cost-effective interventions, Enough drugs, medical supplies, medical apparatuses and equipment, Up-to-date technologies for patient diagnosis, Up-to-date and appropriate guidelines and protocols, Improved treatment and respect to patients, Services to patients using mode of communication suitable to patients, Federal Democratic Republic of Ethiopia Ministry of Health. Olukoga A, Bachmann M, Harris G, Olukoga T, Oluwadiya K. Analysis of the perception of institutional function for health sector reform in Nigeria. Regarding health workforce, only a fraction of the WHO building block for workforce was achieved. Federal Democratic Republic of Ethiopia Ministry of Health. On-time access to services and availability of services in a mode of communication suitable to patients both scored 69%. The Alliance is working with district health teams, national governments, WHO programmes and researchers to generate evidence on applied systems thinking. Addis Ababa, Ethiopia: FMoH; 2015. http://globalfinancingfacility.org/sites/gff_new/files/documents/HSTP%20Ethiopia.pdf, Federal Democratic Republic of Ethiopia Ministry of Health (FMoH). In South Sudan, under the World Bank Rapid Results for Health Project (RRHP), IMAWorld Healthimproved the delivery of high impact primary health care (PHC) services at 284 PHC facilities. The use of the six WHO health system building blocks was proved to be instrumental for assessing and following-up of the overall healthcare system. The pandemic has been a significant setback in our efforts to support Member States to progress towards universal health coverage, said WHO Director-General Dr Tedros Adhanom Ghebreyesus. Health information is one of six core functions of the health system (USAID, 2015). An HIS encompasses all health data sources required by a country to plan and implement its national health strategy. The six blocks allow identifying different improvement opportunities in each one of the hospitals. 2011;26(4):31626. the contents by NLM or the National Institutes of Health. We strengthen national medicine distribution systems, establishing a pull system that giveseach health facility a line of credit to purchaselow cost, high qualitymedicine based on theirpatient intake.