What is a Health System?

The World Health Organization (WHO) defines a health system as “all the organizations, institutions, resources and people whose primary purpose is to improve health” (World Health Organization, 2010). Alternatively, it can be defined as “all the activities whose primary purpose is to promote, restore, or maintain health” (World Health Organization, 2000).

This definition directly includes medical care provided in clinical settings, like what might come to your mind when you consider the term “health system,” but a health system also encompasses services offered by traditional healers and community health workers, family members, and caregivers; health education activities; pharmaceuticals; public health campaigns; sanitation; education; and other strategies directed at influencing the broader, social determinants of health. While the level of integration and overall organization varies from country to country, every country has some type of health system. In order to effectively improve, promote, and restore health, a health system requires a qualified workforce, sufficient infrastructure, adequate financing, and proper management.

In fact, there are six core components or “building blocks” that the WHO considers as a framework for describing and evaluating health systems: service delivery; health workforce; health information systems; access to essential medicines; financing; and leadership and governance (World Health Organization, 2010). These components, in combination, should work towards achieving the overall goals of health systems: improved health, both in terms of the level of health and health equity; responsiveness to the health needs and expectations of a population; social and financial risk protection; and improved efficiency (World Health Organization, 2010). Adopting indicators to measure health system performance in each of these core areas has facilitated the comparison of health systems and has also provided a means to evaluate efforts directed at health system strengthening over the past several decades.

What are the Functions of a Health System?

The World Health Report 2000 identified four primary functions of health systems: 1) provide health services; 2) generate resources, or raise money, that can be spent on health related services and activities; 3) finance, or pay for, health services; and 4) provide stewardship over, or regulate and govern, the health system (World Health Organization, 2010).

In order to fulfill these functions, all health systems should strive to:

• provide a comprehensive range of health services across the continuum of care (prevention, diagnosis, treatment, rehabilitation, and palliative care);

• protect individuals and families from excessive financial burdens associated with poor health or disability (typically through health insurance or other types of risk-pooling strategies); and

• appropriately manage and regulate the health system to ensure quality, equity, safety, fairness and responsiveness. This includes supervising key public health functions (for example, disease surveillance and monitoring, public health laboratories, and food and drug regulation) (Skolnik, 2023).

There is a lot of variation in health systems around the world. How a health system is organized, financed, and how it functions tend to reflect the history, culture, politics, and economic capacity of the country it serves. All countries, regardless of income level, have to balance health expenditures with available resources. As countries experience economic growth, they tend to spend more per capita on health relative to lower-income countries. Likewise, they tend to place a greater emphasis on trying to ensure universal access to at least a basic package of health services and to some type of health insurance program (Skolnik, 2023). However, even low-income countries can progress toward these goals. In some countries, the government is the sole or primary provider, as well as “payer,” for health services. In other countries, services are provided by a combination of public and private providers, but are still primarily paid for through a national health insurance program. In others, there is a more pluralistic provision of services and financing through a combination of the public sector, private sector, non-profit sector, and out-of-pocket payments by patients (Skolnik, 2023). Regardless of the differences that can be noted between health systems, most health systems have some common elements. Health systems are often categorized into four different types: the Beveridge Model, the Bismarck Model, the National Health Insurance Model, and the Out-of-Pocket Model.

What are the Main Types of Health Systems? 

(Briony Harris, 2020)

There are four main types of healthcare systems in place around the world (excluding the system in the United States, where there is no single nationwide model and healthcare is paid for through private insurance or provided by the government to some groups). The following infographic summarizes the models outlined in detail below.

The way these systems are funded is what sets them apart, but what they all need now is additional resources to cope with unprecedented demand. The chart below shows recent levels of healthcare spending as a proportion of GDP. Whichever of the four systems is in place, healthcare spending will see a spike as the coronavirus pandemic demands ever more resources.

Four ways of providing healthcare

Let’s take a closer look at the four key types of healthcare systems and how they aim to meet the medical needs of populations. They are known as the Beveridge Model, the Bismarck Model, the National Health Insurance Model, and the Out-of-Pocket Model.

The Beveridge Model

In this system healthcare provision is funded by direct income tax deductions. The majority of hospitals are owned and operated by the government. Most healthcare staff including doctors and nurses are employed by the state. The United Kingdom’s National Health Service operates on this model. The model itself takes its name from the economist Sir William Beveridge, who mapped out the introduction of the UK’s welfare state and National Health Service in the years following the end of the Second World War. Spain, Cuba and New Zealand also operate this model of healthcare system.

One of the main advantages of the Beveridge Model is that health services are free at the point of use and are available to every citizen. The government is responsible for funding all health services upfront with money raised from tax deductions. Another advantage, according to the Princeton Public Health Review, is that the single-payer structure in this system keeps costs low as the government is the only purchaser.

But universal access to state-funded medical treatment brings its own pressures. Healthcare systems operating the Beveridge Model are frequently beset by long waiting lists for treatment.

One further challenge now facing governments—especially some in Asia, where aging populations mean there are fewer young people to pay taxes—is how to pump additional funding into health systems when tax revenues have been significantly reduced as the coronavirus pandemic slows economic activity and raises unemployment to historic levels.

The Bismarck Model

This model is funded by insurance payments made jointly by employers and employees. Patients who pay into these schemes have access to ‘sickness funds’ which are used to pay for health services. France, Germany, Japan, and Switzerland operate the Bismarck system.

Most hospitals and health services providers are private institutions although the funds themselves are considered to be public. In this system, the insurers are not allowed to take profits, and the price of health services is tightly controlled by law. This allows governments to keep costs down and operate financial controls in a similar way to the Beveridge Model.

The Bismarck Model was not established to provide universal access to healthcare. It offers cover for those employees who are able to pay into the scheme. However, issues arise around providing coverage for people not in full-time employment or unable to work at all.

Countries with aging populations where a high proportion of adults are beyond working age and are more likely to be affected by chronic health conditions, including noncommunicable diseases, are facing funding challenges.

The National Health Insurance Model

This model takes in elements of the Beveridge and Bismarck models, to strike a balance between public and private health provision. Countries including Canada and South Korea operate the NHI Model.

In this system, the government is the single payer for all health services, which reflects the state’s role under the Beveridge Model. Under the NHI Model, funds are raised through a state-operated insurance scheme that every citizen pays into. The insurance program is not-for-profit and no claim is denied.

The majority of health service providers are privately-owned companies as is the case with the Bismarck Model.

The NHI Model has the advantage of providing access to healthcare for all citizens and the centralized management of the insurance scheme cuts the administration burden for hospital managers who only have to deal with a single funding provider.

However, this system can lead to long waiting lists as the image below illustrates. According to Canada’s Fraser Institute think tank, the median wait time for medically necessary treatment in Canada was 20.9 weeks in 2019. In some regions, the wait can increase to almost a year.

In addition to the pressures caused by long waiting lists, aging populations will also bring funding and capacity challenges to countries operating the NHI system.

The Out-of-Pocket Model

This method of access to healthcare is most common in developing countries where no formal state-wide system exists. People in rural areas of India and China as well as parts of Africa and South America source healthcare in this way. Health services are not always available and even when they are, they are beyond the financial means of many people.

So what does “out of pocket” mean in this context? Put simply, anybody requiring medical treatment must pay for it on the spot. There is no universal insurance system and income taxes are not raised to provide access to healthcare for all citizens. The reality of this means the world’s poorest people are frequently denied access to health care.

The numbers are staggering. A 2017 report from the World Health Organization and the World Bank concluded that half the world’s population had no access to essential healthcare. Another 100 million people were being pushed into extreme poverty because of the cost of healthcare.

Meeting global health goals

Each of the models above is facing challenges that will create obstacles to meeting the United Nations Sustainable Development Goals on health. Some of these challenges are at a critical stage already, while others will intensify over time as populations age and technology has an impact on the way we work.

Ensuring every person can live a healthy life and promoting well-being at all ages is the third Sustainable Development Goal.

Exploring new methods of paying for and delivering care could form part of the solution. The World Economic Forum, for example, is working with pharmaceutical multinational Sanofi and professional services firm Klynveld Peat Marwick Goerdeler (KPMG) to find new ways of achieving better health outcomes with existing resources in the Asia Pacific region.

According to the project: “Helping individuals lead healthier lives calls for new models of financing and delivery systems to reduce disease burden and the rising cost of healthcare.”

What are the Challenges Facing Modern Health Systems?

While many countries have effective health systems, there is not a single perfect health system! All health systems have problems associated with their particular approach. You will notice that there is a constant balancing act between trying to ensure the delivery of quality healthcare to all people and the costs of providing that care. This is a challenge all nations face as they consider health care delivery as a part of their overall society. While financing for health systems is inadequate in many parts of the world, the costs associated with health services and questions about how to finance them is not the only challenge facing modern health systems. Other common issues for health systems around the world include: insufficient or unbalanced human resources; quality of care concerns; weak stewardship; demographic and epidemiologic changes; and access and equity concerns (Skolnik, 2023).

Health systems across all economic levels face human resource issues. Many countries, including high-income countries, often fail to produce sufficient healthcare providers in certain categories to meet the needs of their health systems. Sometimes, they hire healthcare providers from other countries to help partially fill these human resource gaps. This contributes to what is referred to as “brain drain,” when healthcare professionals trained in middle- or low-income countries emigrate from their native countries to another, typically higher-income country in search of a better standard of living, higher wages, and more stable or advanced working conditions. This loss of healthcare professionals is particularly detrimental to low- and middle-income countries, which have invested in educating and training these healthcare professionals but do not reap the benefits of having additional healthcare workers available to serve in their own systems.

Many low- and middle-income countries have deficits in healthcare providers that are much more severe than those experienced in high-income countries. The quality of training and preparation for healthcare providers in many countries is also often inadequate. While responsibility for the problem of brain drain is one shared by high- and low-income countries alike, there are some efforts that are being explored for enhancing the education and training of healthcare workers and also for increasing the retention of health personnel. Some countries, for example, have developed systems to train healthcare workers so that they develop adequate skills but are not eligible for receiving credentials that would be recognized by other countries (limiting their ability to seek employment elsewhere) (Skolnik, 2023). Task shifting and task sharing, or training lower-level staff to perform functions that would normally be reserved for high-level healthcare personnel, is another example of a partial solution for human resource issues within health systems. Examples of task shifting include nurses or midwives being trained to perform cesarean sections, or community health workers being trained to identify and treat children with uncomplicated pneumonia or to provide basic mental health services (Centers for Disease Control and Prevention, 2022).

Weak overall governance and corruption within countries often extend into health system governance. In general, health systems in high-income countries are well-regulated and operate with high levels of efficiency, transparency, and a lack of corruption (Skolnik, 2023). Sadly, the same is not true in many low- and middle-income countries where established rules and regulations within the health sector are poorly enforced. Though it is a challenge to improve health system governance and stewardship in countries with poor general government oversight and integrity, there are some strategies that have demonstrated success in improving health system governance. These include: contracting out some health services to the private for-profit or non-profit sector; pay-for-performance incentive programs for healthcare providers; and utilizing customer satisfaction surveys or allowing communities to provide “report cards” for the health system (Skolnik, 2023).

Demographic and epidemiologic changes are also creating new demands and pressures on health systems. As life expectancy across the globe increases due to successful public health initiatives, economic development, and other factors, more and more people are living to advanced ages. Age is a leading non-modifiable risk factor for many health conditions and especially for noncommunicable diseases. Because of their chronic nature, the healthcare costs associated with noncommunicable diseases are significantly higher than costs associated with most communicable diseases. Though we have made huge strides in addressing the burden of disease linked with communicable diseases globally, infectious diseases and acute health conditions continue to play an important role in global morbidity and mortality (especially for young populations and low- and middle-income countries). This trend towards increasing rates of noncommunicable diseases in combination with ongoing burdens from communicable diseases contributes to a “double burden of disease” in many countries. Likewise, given trends towards lower fertility rates as countries develop economically, the ratio of elderly to younger populations is also increasing in many parts of the world. Since health insurance programs and health care systems are often funded through taxes and contributions made through employers, this ratio of older (no longer paying into the system) to economically active (working, tax-paying) individuals is also increasing financial pressures on health systems. The need for countries, especially low- and middle-income countries to emphasize preventive health measures that can help reduce the future burden of cardiovascular and other chronic diseases (for example, tobacco control measures) is high (Skolnik, 2023). General measures to increase the capacity of health systems in low- and middle-income countries to handle the growing burden of noncommunicable diseases are also necessary.

In addition to challenges related to financing health services, human resource concerns, poor governance, and demographic and epidemiologic changes, there are many health systems that struggle with overcoming health disparities that are inherent to their structure and function. For example, the physical location of health facilities in many low- and middle-income countries makes it difficult for some populations to access health services. This is especially true for rural populations as well as for poor and minority populations. The health facilities that these populations may be able to reach are often under-supplied and poorly staffed or are only staffed by lower-level healthcare providers who don’t have the knowledge and skills to address more complex health concerns (Skolnik, 2023). Oftentimes, patients are also required to pay out of pocket for health services, which presents another barrier for economically vulnerable populations in accessing the care that they need. All of these barriers result in generally worse health status and health outcomes among rural populations and the poor. Increasing access to certain health services like those targeting childhood vaccinations, Tuberculosis, and malaria has the potential to reduce health disparities and to improve the health status of populations in many countries. Improving access and equity within health systems can be accomplished by emphasizing primary health care and universal health coverage, which are described in the next sections.

Levels of Care

Health systems, in terms of how they provide formal medical care, are typically divided into three levels of care: primary care, secondary care, and tertiary care. The primary care level is typically the first point of contact a patient would have with the health system. In high-income countries, this level of care is typically provided by a local physician; secondary care is typically provided by physicians and general hospitals; and tertiary care is typically provided in specialized hospitals. In many low- and middle-income countries, primary, secondary, and tertiary care facilities are organized geographically according to population density. A primary care facility, potentially staffed by nurses, medical assistants or nurse-midwives rather than physicians, might be established for every 5,000-10,000 people in a population. A secondary hospital might be located in each district, with a tertiary hospital located in large cities (Skolnik, 2023). Given that it is typically the most affordable and accessible level of healthcare in any given setting, ensuring access to primary healthcare, as part of efforts to ensure universal health coverage, has been a global health priority in recent decades.

Primary Health Care 

(World Health Organization, 2021)

Key facts

• About 930 million people worldwide are at risk of falling into poverty due to out-of-pocket health spending of 10% or more of their household budget.
• Scaling up primary health care (PHC) interventions across low and middle-income countries could save 60 million lives and increase average life expectancy by 3.7 years by 2030.
• Achieving the targets for PHC requires an additional investment of around US$ 200 to US$ 370 billion a year for a more comprehensive package of health services.
• At the UN high level UHC meeting in 2019, countries committed to strengthening primary health care. WHO recommends that every country allocate or reallocate an additional 1% of GDP to PHC from government and external funding sources.

What is primary health care (PHC)?

The concept of PHC has been repeatedly reinterpreted and redefined in the years since 1978, leading to confusion about the term and its practice. A clear and simple definition has been developed to facilitate the coordination of future PHC efforts at the global, national, and local levels and to guide their implementation:

"PHC is a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people’s everyday environment." WHO and UNICEF. A vision for primary health care in the 21st century: Towards UHC and the SDGs.

PHC entails three interrelated and synergistic components, including comprehensive integrated health services that embrace primary care as well as public health goods and functions as central pieces; multi-sectoral policies and actions to address the upstream and wider determinants of health; and engaging and empowering individuals, families, and communities for increased social participation and enhanced self-care and self-reliance in health.

PHC is rooted in a commitment to social justice, equity, solidarity and participation. It is based on the recognition that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction.

For universal health coverage (UHC) to be truly universal, a shift is needed from health systems designed around diseases and institutions towards health systems designed for people, with people. PHC requires governments at all levels to underscore the importance of action beyond the health sector in order to pursue a whole-of-government approach to health, including health-in-all-policies, a strong focus on equity and interventions that encompass the entire life-course.

PHC addresses the broader determinants of health and focuses on the comprehensive and interrelated aspects of physical, mental and social health and wellbeing. It provides whole-person care for health needs throughout the lifespan, not just for a set of specific diseases. Primary health care ensures people receive quality comprehensive care - ranging from promotion and prevention to treatment, rehabilitation and palliative care - as close as feasible to people’s everyday environment.

Why is primary health care important?

PHC is the most inclusive, equitable, cost-effective and efficient approach to enhance people’s physical and mental health, as well as social well-being. Evidence of the wide-ranging impact of investment in PHC continues to grow around the world, particularly in times of crisis such as the COVID-19 pandemic.

Across the world, investments in PHC improve equity and access, health care performance, accountability of health systems, and health outcomes. While some of these factors are directly related to the health system and access to health services, the evidence is clear that a broad range of factors beyond health services play a critical role in shaping health and well-being. These include social protection, food systems, education, and environmental factors, among others.

PHC is also critical to make health systems more resilient to situations of crisis, more proactive in detecting early signs of epidemics and more prepared to act early in response to surges in demand for services. Although the evidence is still evolving there is widespread recognition that PHC is the “front door” of the health system and provides the foundation for the strengthening of the essential public health functions to confront public health crises such as COVID-19.

Universal Health Care 

(World Health Organization, 2022)

Key facts

• The UHC service coverage index (SDG indicator 3.8.1) increased from 45 in 2000 to 67 in 2019, but 30% of the world’s population still cannot access essential health services.
• Almost 2 billion people are facing catastrophic or impoverishing health spending (SDG indicator 3.8.2).
• Inequalities continue to be a fundamental challenge for UHC as aggregated data masks within-country inequalities in service coverage.
• The COVID-19 pandemic further disrupted essential services in 92% of countries.
• To build back better, WHO’s recommendation is to reorient health systems to primary health care (PHC). Most (90%) of essential UHC interventions can be delivered through PHC and 75% of projected health gains from the SDGs could be achieved through PHC.

Overview

Universal health coverage (UHC) means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course.

The delivery of these services requires health and care workers with an optimal skills mix at all levels of the health system, who are equitably distributed, adequately supported with access to quality assured products, and enjoying decent work.

Protecting people from the financial consequences of paying for health services out of their own pockets reduces the risk that people will be pushed into poverty because unexpected illness requires them to use up their life savings, sell assets, or borrow – destroying their futures and often those of their children.

Achieving UHC is one of the targets the nations of the world set when they adopted the 2030 Sustainable Development Goals (SDGs) in 2015. At the United Nations General Assembly High Level Meeting on UHC in 2019, countries reaffirmed that health is a precondition for and an outcome and indicator of the social, economic and environmental dimensions of sustainable development. WHO’s Thirteenth General Programme of Work aims to have 1 billion more people benefit from UHC by 2025, while also contributing to the targets of 1 billion more people better protected from health emergencies and 1 billion more people enjoying better health and well-being.

Progress towards UHC

Prior to the COVID-19 pandemic, there was worldwide progress towards UHC. The UHC service coverage index (SDG indicator 3.8.1) increased from 45 in 2000 to 67 in 2019, with the fastest gains in the WHO African Region. However, 2 billion people are facing catastrophic or impoverishing health spending (SDG indicator 3.8.2).

Inequalities continue to be a fundamental challenge for UHC. Even where there is national progress on health service coverage, the aggregate data mask within-country inequalities. For example, coverage of reproductive, maternal, child and adolescent health services tends to be higher among those who are richer, more educated, and living in urban areas, especially in low-income countries. On financial hardship, people living in poorer households and in households with older family members (those aged 60 and older) are more likely to face financial hardship and pay out of pocket for health care. Monitoring health inequalities is essential to identify and track disadvantaged populations in order to provide decision-makers with an evidence base to formulate more equity-oriented policies, programmes and practices towards the progressive realization of UHC. Better data also is needed on gender inequalities, socioeconomic disadvantages, and specific issues faced by indigenous peoples and refugee and migrant populations displaced by conflict and economic and environmental crises.

During COVID-19, 92% of countries reported disruptions to essential services. Some 25 million children under 5 years missed out on routine immunization. There were glaring disparities in access to COVID-19 vaccines, with an average of 24% of the population vaccinated in low-income countries compared to 72% in high-income countries. Potentially life-saving emergency, critical and operative care interventions also showed increased service disruptions, likely resulting in significant near-term impact on health outcomes.

As a foundation for and way to move towards UHC, WHO recommends reorienting health systems to primary health care (PHC). PHC enables universal, integrated access in everyday environments to the full range of quality services and products people need for health and well-being, thereby improving coverage and financial protection. Most (90%) essential UHC interventions can be delivered through PHC and there are significant cost efficiencies in using an integrative PHC approach. Some 75% of the projected health gains from the SDGs could be achieved through PHC, including saving over 60 million lives and increasing average global life expectancy by 3.7 years by 2030.

Strengthening health systems based on PHC should result in measurable health impact in countries.

Can UHC be measured?

Yes. Monitoring health inequalities is essential to identify and track disadvantaged populations in order to provide decision-makers with an evidence base to formulate more equity-oriented policies, programmes and practices towards the progressive realization of UHC. In the SDG’s, progress on UHC is tracked using two indicators:

• coverage of essential health services (SDG 3.8.1), and
• catastrophic health spending (and related indicators) (SDG 3.8.2).

Detailed data is provided in the WHO Global Health Observatory Data Repository for UHC.

Global Health Organizations

While the public sector is generally very important within health systems, it is not the only sector important in providing health services or in addressing health needs of a population. There are a lot of organizations in a number of different sectors working to address health issues throughout the world. While there are so many agencies and organizations that are active in global health that it’s not practical to list them all, it is helpful to understand some of the main categories of organizations and the roles they typically play in global health.

Multilateral Organizations receive funding from multiple governments (three or more) and private sources to address issues in many different countries. This allows them to effectively pool resources and encourage cooperation in supporting the global health agenda. United Nations agencies like the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), and the Joint United Nations Programme on HIV/AIDS (UNAIDS) fall under the category of multilateral organizations. The WHO promotes the attainment of the highest possible level of health for all people, while UNICEF is the UN agency that is primarily focused on the health and wellbeing of children around the globe. UNAIDS is focused on the control and prevention of HIV/AIDS and on ending HIV/AIDS as a public health threat. There are also multilateral development banks like the World Bank that qualify as multilateral organizations. They are owned or financed by multiple member countries, and serve as intermediaries to channel financial resources from high-income countries to low- and middle-income countries to help them in development activities. Many of the development initiatives funded by the World Bank and similar multilateral development banks support efforts in the health sector.

Bilateral Organizations are governmental agencies based in a single, typically high-income, country that focus their efforts on developmental assistance for specific low- and middle-income countries, often based on political and or historical reasons (for example, former colonial relationships or the desire to promote foreign policy goals). These organizations represent direct development aid from one country to another. For example, the United States Agency for International Development (USAID) is the development assistance agency for the U.S. government. USAID and similar bilateral development assistance agencies based in other countries are heavily involved in funding, advocating for, and providing technical expertise in global health initiatives.

Foundations, or organizations with large endowments that allow them to invest in specific projects and initiatives that align with their mission and goals, are critical sources of financing for global health. Because of how they are funded, foundations are often able to finance longer-term or “riskier” initiatives that government (multinational and bilateral agencies) are not willing to invest in and that non-governmental agencies do not have the resources to support. Among many other things, they play an important role in innovation and in the development of new technologies and tools for health.

Non-governmental organizations (NGOs) are organizations not affiliated with governments. They can be secular or faith-based, and they vary widely in terms of the health issues that they address and their geographical reach. Most of them are funded through private resources and fundraising efforts, as well as through grants and partnerships with other health agencies. Non-governmental organizations are frequently implementing agencies or the “boots on the ground” for global health programs funded by these other categories of global health players. A few examples of important NGOs involved in global health are provided in the table below.

You are encouraged to visit the websites of these organizations to learn more about their activities and efforts in global health.

Note that there are many organizations that do not fall under these categories that are also important players in global health. You may come across some of them as you complete your country projects this semester.

Optional Video Resources

Global Health with Greg Martin - Health Systems

Global Health with Greg Martin - Universal Health Care Explained

Public Health Lectures - Health Systems - Introduction

Public Health Lectures - Health Systems - Delivering Health Services

Public Health Lectures - Health Systems - Financing

Public Health Lectures - Health Systems - Politics and Universal Health Coverage

Global Health with Greg Martin - Top 10 Organizations to Work for in Global Health

International Agencies: Bilateral Agencies, Non-Government Organizations (NGOs), and Other Agencies

References

Briony Harris. (2020, October 9). The world has 4 key types of health service – this is how they work. World Economic Forum. https://www.weforum.org/agenda/2020/10/covid-19-healthcare-health-service-vaccine-health-insurance-pandemic/

Centers for Disease Control and Prevention. (2022, June 17). Sharing and Shifting Tasks to Maintain Essential Healthcare During COVID-19 in Low Resource, non-US settings. CDC. https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/task-sharing.html#annex2

Skolnik, R. L. (2023). Global population health: A primer. Jones & Bartlett Learning.

World Health Organization. (2000). The world health report. 2000: Health systems: improving performance. https://apps.who.int/iris/bitstream/handle/10665/42281/WHR_2000-eng.pdf?sequence=1&isAllowed=y

World Health Organization. (2010). Monitoring the building blocks of health systems: A handbook of indicators and their measurement strategies. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/258734/9789241564052-eng.pdf

World Health Organization. (2021, April 1). Primary health care. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/primary-health-care

World Health Organization. (2022, December 12). Universal health coverage (UHC). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)