Module: Health systems, economics and policy

Topic 7


Topic 7: Administering the Health System

Objectives/learning outcomes

 

Students will be able to:

Recognise, understand and critically examine concepts of decentralization and integration.


 

Seminar: Where does planning authority lie?

 

Apply the Lavis et al (Lewin, 2008) framework to a specific health system and determine where authority lies with respect to at least two of the following:

  • Policy authority—e.g., who makes policy decisions about what primary health care encompasses (such as whether such decisions are centralised or decentralised)
  • Organisational authority—e.g., who owns and manages primary health-care clinics (such as whether private for-profit clinics exist)
  • Commercial authority—e.g., who can sell and dispense antibiotics in primary health care and how they are regulated
  • Professional authority—e.g., who is licenced to deliver primary health-care services; how is their scope of practice determined; and how they are accredited
  • Consumer and stakeholder involvement—who from outside government is invited to participate in primary health-care policy-making processes and how are their views taken into consideration

 

You should refer to WHO databases when preparing a short class presentation.

 


Set reading

ESSENTIAL READING

Lewin S (2008) Supporting the delivery of cost-effective interventions in primary health-care systems in low-income and middle-income countries: an overview of systematic reviews. Lancet; 372: 928–39. (read it here)

Maeseneer J (2009) Primary Health Care in Africa: Now more than ever. African Journal of Primary Healthcare and Family Medicine, 112 (read it here)

Maeseneer J (2008) From Alma-Ata to Almaty: a new start for Primary Healthcare (read it here)

ADDITIONAL READING

Black N and Gruen R (2005) Understanding health services. Maidenhead: Open University Press. (Section 5) (Check library availability or buy it here)

World Health Organization (2008) World Health Report 2008. Geneva: WHO, overview and chapter 1.

Lecture: The continuum of administrative tools

 

Administrative structures reflect the goals and functions set for a health system and complement financing as a redistributive mechanism. They can be viewed on a broad continuum according to their reliance on public or market planning systems. Publicly administered redistribution (as distinct from allocation through the market) requires structures for allocating resources according to health care needs, namely, adequate planning tools and resources, planning powers and appropriate population-based data. Market planning requires different tools. In this lecture we will contrast administrative systems designed for universal access with those designed for other purposes.

Lecture Notes and Powerpoints