tailieunhanh - Gynecological care and the health system

Chapter aims to give an introduction into the com-plexities of healthcare delivery and to sensitizing health providers on issues outside immediate healthcare provision. The example of ‘introduction of a program for cervical cancer screening’ will be used throughout this chapter as a guide through different aspects of the health system. | 36 Gynecological Care and the Health System Claudia Hanson INTRODUCTION Healthcare delivered at the hospital level is closely related to the functioning of the whole health system in a country and these systems are very complex. The World Health Organization WHO defines health systems as all actions in a society that are primarily intended to improve health 1. Further WHO categorizes health systems into six building blocks governance and leadership financing the health workforce including education and employment procurement and provision of medical products vaccines and technology information including health management information systems and service delivery2 see Box 1 . The characterization of these different aspects will be described in more detail below. Apart from the formal health sector with the public private-for-non-profit non-governmental organizations NGO or mission hospitals and private-for-profit health facilities health systems include the informal sector including traditional healers and traditional midwifes. Looking at the complexities of health systems at the local level in a more structured way can help to improve the quality of care offered. Using the elements of the six health system blocks can help to structure health planning such as for gynecological Box 1 The six health system building blocks1 Governance and leadership Financing Health workforce Medical products vaccines technology Information Service delivery care. For example setting up a program for screening of cervical cancer needs more than just the training of health workers and information to the community. Planning needs to include sustainable financing leadership and responsibility organization of service delivery reliable provision of testing equipment establishment of monitoring and evaluation procedures and many more elements. This chapter aims to give an introduction into the complexities of healthcare delivery and to sensitizing health providers on issues outside immediate .