High-quality health systems in the Sustainable Development Goals era: time for a revolution

Abstract

<p>Although health outcomes have improved in low-income and middle-income countries (LMICs) in the past several decades, a new reality is at hand. Changing health needs, growing public expectations, and ambitious new health goals are raising the bar for health systems to produce better health outcomes and greater social value. But staying on current trajectory will not suffice to meet these demands. What is needed are high-quality health systems that optimise health care in each given context by consistently delivering care that improves or maintains health, by being valued and trusted by all people, and by responding to changing population needs. Quality should not be the purview of the elite or an aspiration for some distant future; it should be the DNA of all health systems. Furthermore, the human right to health is meaningless without good quality care because health systems cannot improve health without it.</p>\n\n<p>We propose that health systems be judged primarily on their impacts, including better health and its equitable distribution; on the confidence of people in their health system; and on their economic benefit, and processes of care, consisting of competent care and positive user experience. The foundations of high-quality health systems include the population and their health needs and expectations, governance of the health sector and partnerships across sectors, platforms for care delivery, workforce numbers and skills, and tools and resources, from medicines to data. In addition to strong foundations, health systems need to develop the capacity to measure and use data to learn. High-quality health systems should be informed by four values: they are for people, and they are equitable, resilient, and efficient.</p>

Keywords

Affiliated Institutions

• Harvard Global Health Institute US
• Harvard University US
• Inter-American Development Bank US
• London School of Hygiene & Tropical Medicine GB
• Gates Foundation US
• Kenya Medical Research Institute KE
• Instituto de Efectividad Clínica y Sanitaria AR
• University of Ibadan NG
• Duke University US
• Public Health Foundation of India IN
• New York College of Health Professions US
• Department of Health ZA
• World Bank US
• Stanford Medicine US
• Northwestern University US
• Mexican Social Security Institute MX
• Institute for Healthcare Improvement US
• Deleted Institution
• Division of Parasitic Diseases and Malaria US
• Center for Global Health US
• Federal Ministry of Health ET
• Government of Ethiopia ET
• New York University US
• University of Bergen
• Centers for Disease Control and Prevention US
• World Health Organization CH
• Malawi University of Science and Technology MW

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