This paper investigates the advantages of using Systems Thinking and System Dynamics in the analysis of health care systems. It demonstrates that the disappointing results observed in health care management are due to a lack of adoption of systemic methods to study these systems. The paper portrays the consequences and causes of policy resistance in health care systems and how they can be overc...

In the recent years most African countries have embarked on a series of reforms involving the decentralisation and also integration of health information systems in order to allow improved efficiency and effectiveness in the health care. However, although the discourse around these issues are reflected in global policy documents of almost twenty years ago, IS are still fragmented and weak at th...

In the recent years most African countries have embarked on a series of reforms involving the decentralisation and also integration of health information systems in order to allow improved efficiency and effectiveness in the health care. However, although the discourse around these issues are reflected in global policy documents of almost twenty years ago, IS are still fragmented and weak at th...

Many countries in Africa have embarked on health sector reforms. The design of the reforms differs considerably. A key feature of the reforms is decentralization, of which Uganda and Zambia are implementing two different models. This paper analyses the two models of health sector reform, and their implications for ultimate development goals. In Uganda, the whole government has been decentralize...

As many low- and middle-income countries (LMICs) pursue health care reforms in order to achieve universal health coverage (UHC), development of national accreditation systems has become an increasingly common quality-enhancing strategy endorsed by payers, including Ministries of Health. This article describes the major considerations for health system leaders in developing and implementing a su...

This paper introduces a conceptual framework to investigate the equity consequences of resource allocation, strategic purchasing and payment system reforms (RAP) in health, and reviews the empirical literature that has analyzed the impact of these reforms on equity. In the first part, the paper reviews the existing evidence on the distribution of health and health care utilization across socio-...

BACKGROUND Primary health care (PHC)-based reforms have had different results in Latin America. Little attention has been paid to the enablers of collective action capacities required to produce a comprehensive PHC approach. OBJECTIVE To analyse the enablers of collective action capacities to transform health systems towards a comprehensive PHC approach in Latin American PHC-based reforms. ...

Unlike the managerially oriented reforms that have brought auditing and accounting into such prominence in the UK National Health Service (NHS), and which seem alien to the culture of the caring professions, consumerist reforms may seem to complement moves towards the acceptance of wide definitions of health, and towards increasing patient autonomy. The empowerment favoured by those who support...

This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the "Result Chain" logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impac...

Since regaining its independence in 1991, Estonia has conducted radical health system reforms. The Estonian health system is based on mandatory, solidarity-based insurance and universal access to health services made available by providers operating under private law with primary health care (PHC) playing a central role. The financing of health care is mainly organized through the semi-autonomo...