Abstract
The WHO Framework on Health Systems Performance Assessment is an attempt to accelerate the development of an evidence-based on the outcomes of health systems and of the determinants of these outcomes. Used in the World Health Report 2000 it elicited discussions of health policy or health system reform which often become ideological debates that are fuelled by non-comparable results from studies in which differing methods were used. In Vicente Navarros critique it seems that Navarro have misinterpreted the fundamental principles of the WHO Framework: to clarify the boundaries of health systems; to assess how health and other systems interact to achieve key social goals; to define and measure health responsiveness and fairness in financial contribution; and ultimately to show the importance of transparency and accountability for the worlds health systems. This paper extensively discusses these principles as an answer to Navarros comments. It includes explanations about the WHO Frameworks social systems and goals attainment and efficiency assessment of health system goals and accountability and transparency.
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