Decomposing Performance Assessment of Health Systems toward Greater Resilience and Sustainability in Africa

Abstract

Recent events warrant the need for new perspectives on the concepts of resilience and sustainability. Notably, discussions on the resilience and sustainability of health systems have surged since the emergence of the global pandemic. The WHO has since called on practitioners to improve on health system’s performance. This examination provides an assessment of resilience and sustainability of African health systems within the OECD by determining a performance threshold against which the performance is compared as well as decomposition of the performance on both dimensions of performance. Data were sourced on indicators representing resilience and sustainability dimensions from 26 African states in the OECD database. Findings reveal low resilience and satisfactory levels of sustainability among the health systems. Kenya, Cabo Verde, and Mauritania show sufficient sustainability. At the same time, no system showed sufficient resilience to meet the acceptable performance threshold. Target Audience The chapter offers valuable insights to health professionals, public, and private practitioners in diverse ways. First, it sheds light on the state of resilience and sustainability among African health systems. To this end, it proposes an approach for assessing the performance of the systems along with the objectives of sustainability and resilience. For instance, by decomposing the closeness coefficient score for each objective, professionals are likely to observe the specific performance of complex systems on multiple objectives. This determines a specific dimension of focus, or which require remedial action. In addition, this chapter largely focuses on the threshold determination aspects of system performance. Thus far, it offers a goal-oriented assessment procedure that can be valuable for judging the actual and expected performance.