Abstract
BackgroundAcknowledging the health system strengthening agenda, the World Health Organization (WHO) has formulated a health systems framework that describes health systems in terms of six building blocks. This study aimed to determine the current status of the six WHO health system building blocks in public healthcare facilities in Ethiopia.MethodsA quantitative, cross-sectional study was conducted in five public hospitals in central Ethiopia which were in a post-reform period. A self-administered, structured questionnaire which covered the WHO’s six health system building blocks was used to collect data on healthcare professionals who consented. Data was analyzed using IBM SPSS version 20.ResultsThe overall performance of the public hospitals was 60% when weighed against the WHO building blocks which, in this procedure, needed a minimum of 80% score. For each building block, performance scores were: information 53%, health workforce 55%, medical products and technologies 58%, leadership and governance 61%, healthcare financing 62%, and service delivery 69%. There existed a significant difference in performance among the hospitals (p < .001).ConclusionThe study proved that the WHO’s health system building blocks are useful for assessing the process of strengthening health systems in Ethiopia. The six blocks allow identifying different improvement opportunities in each one of the hospitals. There was no contradiction between the indicators of the WHO building blocks and the health sustainable development goal (SDG) objectives. However, such SDG objectives should not be a substitute for strategies to strengthen health systems.
Highlights
Acknowledging the health system strengthening agenda, the World Health Organization (WHO) has formulated a health systems framework that describes health systems in terms of six building blocks
This study aimed to find out the current status of the six WHO health system building blocks in public healthcare facilities in Ethiopia
The findings revealed that the overall performance of public hospitals which were in a post-reform phase was lesser when weighed against the WHO’s six health system building blocks
Summary
Acknowledging the health system strengthening agenda, the World Health Organization (WHO) has formulated a health systems framework that describes health systems in terms of six building blocks. The various MDG targets for health were instrumental in shaping healthcare outcomes; with a Acknowledging the health system strengthening agenda, the World Health Organization (WHO) has formulated a health systems framework that describes. Manyazewal Archives of Public Health (2017) 75:50 health systems in terms of six building blocks which include service delivery, health workforce, information, medical products, vaccines and technologies, financing, and leadership/governance (Fig. 1) [11]. Strengthening health system means improving these six health system building blocks and managing their interactions in ways that achieve more equitable and sustained improvements across health services and health outcomes which require technical and political knowledge and action [11]. The WHO has supported its health system framework with a monitoring and evaluation framework to monitor program management of health system investments, assess health system performance and evaluate the results of health reform investments [12]
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