THE BUILDING BLOCKS OF THE WORLD HEALTH ORGANIZATION.pdf

The World Health Organization (WHO) Health System Building Blocks are a framework used to strengthen health systems worldwide. These building blocks are essential for delivering quality healthcare services and achieving better health outcomes.

1. THE BUILDING BLOCKS OF THE WORLD HEALTH ORGANIZATION
Introduction
The World Health Organization (WHO) Health System Building Blocks are a framework
used to strengthen health systems worldwide. These building blocks are essential for
delivering quality healthcare services and achieving better health outcomes.
Here are the six WHO Health System Building Blocks:
1. Service Delivery (SD)
Definition
Service delivery refers to the provision of healthcare services to individuals and
communities. It encompasses the entire process of delivering care, from prevention and
diagnosis to treatment and rehabilitation.
Key Components
1. Healthcare Facilities: Hospitals, clinics, health centers, and other facilities that provide
healthcare services.
2. Healthcare Workforce: Doctors, nurses, midwives, and other healthcare professionals
who deliver care.
3. Service Delivery Models: Outpatient, inpatient, emergency, community-based, and
other models of care.
4. Quality of Care: Measures to ensure that care is safe, effective, and patient-centered.
5. Accessibility and Affordability: Efforts to ensure that services are accessible and
affordable for all, regardless of income or social status.
Service Delivery Functions
1. Prevention: Services aimed at preventing illnesses, such as vaccinations and health
education.
2. Diagnosis: Services for diagnosing health problems, including laboratory tests and
imaging studies.
3. Treatment: Services for treating health problems, including medication, surgery, and
other interventions.
4. Rehabilitation: Services aimed at restoring function and promoting recovery after
illness or injury.

2. 5. Palliative Care: Services focused on relieving suffering and improving quality of life for
patients with serious illnesses.
Challenges in Service Delivery
1. Inequitable Distribution of Services: Disparities in access to care, particularly for
vulnerable populations.
2. Inadequate Infrastructure: Insufficient healthcare facilities, equipment, and supplies.
3. Shortage of Healthcare Workers: Insufficient numbers of trained healthcare
professionals.
4. Poor Quality of Care: Substandard care that can lead to adverse outcomes.
5. Financial Barriers: High costs of care that can limit access, particularly for the poor.
Strategies for Improving Service Delivery
1. Strengthening Healthcare Systems: Investing in infrastructure, equipment, and
workforce development.
2. Improving Quality of Care: Implementing quality improvement initiatives and
standards.
3. Increasing Access to Care: Expanding health insurance coverage, reducing financial
barriers, and promoting community-based care.
4. Enhancing Patient-Centered Care: Fostering patient engagement, empowerment,
and satisfaction.
5. Promoting Task Shifting and Task Sharing: Delegating tasks to lesser-trained
healthcare workers to improve efficiency and access.

2. Health Workforce (HW)
Definition
The health workforce refers to all individuals engaged in activities whose primary purpose
is to improve health, including healthcare providers, managers, and support staff.
Key Components
1. Healthcare Providers: Doctors, nurses, midwives, dentists, pharmacists, and other
professionals who deliver healthcare services.
2. Healthcare Managers: Individuals responsible for planning, organizing, and
supervising healthcare services.

3. 3. Healthcare Support Staff: Personnel who assist healthcare providers, such as
administrative staff, laboratory technicians, and healthcare assistants.
Health Workforce Functions
1. Service Delivery: Providing healthcare services to individuals and communities.
2. Health Promotion: Educating and promoting healthy behaviors to prevent illnesses.
3. Disease Prevention: Implementing measures to prevent the spread of diseases.
4. Quality Improvement: Continuously evaluating and improving healthcare services.
5. Leadership and Governance: Providing strategic direction and oversight for
healthcare services.
Challenges Facing the Health Workforce
1. Shortages and Maldistribution: Insufficient numbers of healthcare workers,
particularly in rural and underserved areas.
2. Brain Drain: Migration of healthcare workers from low- and middle-income countries
to high-income countries.
3. Aging Workforce: Increasing numbers of healthcare workers nearing retirement age.
4. Inadequate Training and Education: Insufficient training and education for healthcare
workers, particularly in emerging areas like digital health.
5. Burnout and Mental Health: High levels of stress, burnout, and mental health issues
among healthcare workers.
Strategies for Strengthening the Health Workforce
1. Workforce Planning and Development: Developing strategies to address shortages
and maldistribution.
2. Education and Training: Investing in education and training programs for healthcare
workers.
3. Retention and Motivation: Implementing initiatives to retain and motivate healthcare
workers.
4. Leadership and Management Development : Developing leadership and
management capacity among healthcare workers.
5. Digital Health and Innovation: Leveraging digital health technologies to improve
healthcare delivery and workforce efficiency.

4. 3. Health Information Systems (HIS)
Definition
Health Information Systems refer to the systems and processes used to collect, store,
analyze, and disseminate health data and information.
Key Components
1. Health Data Sources: Various sources of health data, such as:
- Electronic Health Records (EHRs)
- Health Management Information Systems (HMIS)
- Disease Surveillance Systems
- Vital Registration Systems
2. Data Management: Processes for collecting, storing, and managing health data,
including:
- Data collection tools and forms
- Data entry and validation processes
- Data storage and backup systems
3. Data Analysis and Use: Processes for analyzing and using health data to inform
decision-making, including:
- Data analysis software and tools
- Data visualization and reporting techniques
- Data-driven decision-making processes
4. Health Information Technology: The application of information and communication
technologies to support health information systems, including:
- Electronic Health Records (EHRs)
- Telemedicine platforms
- Mobile health (mHealth) applications
Health Information Systems Functions
1. Data Collection: Collecting health data from various sources.
2. Data Analysis: Analyzing health data to identify trends, patterns, and correlations.

5. 3. Data Dissemination: Disseminating health data and information to stakeholders,
including policymakers, healthcare providers, and the public.
4. Decision Support: Providing data-driven insights to support decision-making at
various levels of the health system.
Challenges Facing Health Information Systems
1. Data Quality Issues: Inaccurate, incomplete, or inconsistent health data.
2. Interoperability Challenges: Difficulty sharing and integrating health data across
different systems and platforms.
3. Cybersecurity Concerns: Vulnerability of health information systems to cyber threats
and data breaches.
4. Limited Infrastructure: Inadequate infrastructure, including hardware, software, and
internet connectivity, to support health information systems.
5. Limited Human Resources: Insufficient numbers of skilled health information systems
professionals.
Strategies for Strengthening Health Information Systems
1. Developing Data Standards: Establishing standards for health data collection,
storage, and exchange.
2. Investing in Health Information Technology: Implementing electronic health records,
telemedicine platforms, and other health information technologies.
3. Building Human Resources Capacity: Training and developing health information
systems professionals.
4. Improving Data Quality: Implementing data validation, data cleaning, and data quality
assurance processes.
5. Enhancing Cybersecurity: Implementing robust cybersecurity measures to protect
health information systems from cyber threats.

4. Access to Essential Medicines (AEM)
Definition
Access to Essential Medicines refers to the availability, affordability, and accessibility of
essential medicines, which are defined as those that satisfy the priority healthcare needs
of the population.

6. Key Components
1. Selection of Essential Medicines: Identifying and selecting essential medicines
based on public health needs, evidence-based medicine, and cost-effectiveness.
2. Procurement and Supply Chain Management: Ensuring a reliable and efficient
supply chain for essential medicines, including procurement, storage, and distribution.
3. Affordability and Pricing: Ensuring that essential medicines are affordable and priced
reasonably, taking into account the ability of individuals and households to pay.
4. Accessibility and Availability: Ensuring that essential medicines are available and
accessible to all who need them, regardless of their geographical location or socio-
economic status.
5. Quality Assurance and Safety: Ensuring that essential medicines are of good quality,
safe, and effective.
Functions of Access to Essential Medicines
1. Medicines Selection and Procurement: Selecting and procuring essential medicines
based on public health needs and evidence-based medicine.
2. Supply Chain Management: Managing the supply chain for essential medicines,
including storage, distribution, and inventory management.
3. Price Setting and Reimbursement: Setting prices for essential medicines and
determining reimbursement mechanisms to ensure affordability.
4. Quality Assurance and Safety Monitoring: Ensuring the quality, safety, and efficacy
of essential medicines through monitoring and surveillance.
5. Promoting Rational Use: Promoting the rational use of essential medicines through
education, training, and awareness-raising activities.
Challenges Facing Access to Essential Medicines
1. Limited Availability: Essential medicines may not be available in all areas, particularly
in rural or remote areas.
2. Unaffordability: Essential medicines may be unaffordable for many individuals and
households, particularly in low- and middle-income countries.
3. Poor Quality: Essential medicines may be of poor quality, which can compromise their
safety and efficacy.
4. Inefficient Supply Chain: Inefficient supply chain management can lead to stockouts,
overstocking, and waste of essential medicines.

7. 5. Lack of Transparency and Accountability: Lack of transparency and accountability
in the selection, procurement, and distribution of essential medicines can lead to
corruption and inefficiency.
Strategies for Improving Access to Essential Medicines
1. Strengthening Supply Chain Management: Improving supply chain management
through better procurement practices, inventory management, and distribution systems.
2. Promoting Generic Medicines: Promoting the use of generic medicines, which can
be more affordable and of similar quality to branded medicines.
3. Implementing Price Controls: Implementing price controls and reimbursement
mechanisms to ensure that essential medicines are affordable.
4. Improving Quality Assurance and Safety Monitoring : Strengthening quality
assurance and safety monitoring systems to ensure that essential medicines are of good
quality and safe.
5. Promoting Rational Use: Promoting the rational use of essential medicines through
education, training, and awareness-raising activities.

5. Health Financing (HF)
Definition
Health Financing refers to the mobilization, allocation, and utilization of financial
resources to support the delivery of healthcare services.
Key Components
1. Revenue Collection: Mechanisms for generating revenue for healthcare, such as
taxation, insurance premiums, and out-of-pocket payments.
2. Resource Allocation: Processes for allocating resources to different healthcare
programs and services.
3. Purchasing and Payment: Mechanisms for purchasing healthcare services and
paying healthcare providers.
4. Financial Management: Processes for managing healthcare finances, including
budgeting, accounting, and auditing.
Functions of Health Financing
1. Revenue Generation: Generating revenue for healthcare through various
mechanisms.

8. 2. Resource Allocation: Allocating resources to different healthcare programs and
services based on priority and need.
3. Purchasing and Payment: Purchasing healthcare services and paying healthcare
providers based on performance and quality.
4. Financial Protection: Protecting individuals and households from financial hardship
due to healthcare costs.
5. Efficiency and Effectiveness: Ensuring that healthcare resources are used efficiently
and effectively.
Challenges Facing Health Financing
1. Inadequate Funding: Insufficient funding for healthcare, leading to inadequate
resources and services.
2. Inequitable Financing: Inequitable distribution of healthcare resources, leading to
disparities in access and quality of care.
3. Inefficient Use of Resources: Inefficient use of healthcare resources, leading to
waste and poor health outcomes.
4. Limited Financial Protection: Limited financial protection for individuals and
households, leading to financial hardship due to healthcare costs.
5. Corruption and Mismanagement: Corruption and mismanagement of healthcare
resources, leading to poor health outcomes and inefficient use of resources.
Strategies for Improving Health Financing
1. Increasing Funding: Increasing funding for healthcare through various mechanisms,
such as taxation and insurance premiums.
2. Improving Efficiency: Improving the efficiency of healthcare resource use through
better management and allocation of resources.
3. Enhancing Financial Protection: Enhancing financial protection for individuals and
households through mechanisms such as insurance and subsidies.
4. Promoting Transparency and Accountability : Promoting transparency and
accountability in healthcare financing through mechanisms such as auditing and
reporting.
5. Strengthening Health Systems: Strengthening health systems through better
governance, management, and delivery of healthcare services.

9. 6. Leadership and Governance (L&G)
Definition
Leadership and Governance refer to the processes and structures that guide and manage
the health system, ensuring that it is responsive, equitable, and effective.
Key Components
1. Policy Development: Developing policies that guide the health system, including laws,
regulations, and guidelines.
2. Strategic Planning: Developing strategic plans that outline the vision, mission, and
objectives of the health system.
3. Leadership: Providing leadership that inspires, motivates, and empowers healthcare
workers and stakeholders.
4. Governance: Establishing governance structures that ensure accountability,
transparency, and participation.
5. Regulation and Accreditation: Regulating and accrediting healthcare providers and
services to ensure quality and safety.
Functions of Leadership and Governance
1. Setting Direction: Setting the vision, mission, and objectives of the health system.
2. Mobilizing Resources: Mobilizing financial, human, and technological resources to
support the health system.
3. Building Partnerships: Building partnerships with stakeholders, including healthcare
providers, communities, and donors.
4. Ensuring Accountability: Ensuring accountability and transparency in the health
system.
5. Promoting Quality and Safety: Promoting quality and safety in healthcare services.
Challenges Facing Leadership and Governance
1. Weak Governance: Weak governance structures and processes that hinder
accountability and transparency.
2. Lack of Leadership: Lack of effective leadership that inspires and motivates
healthcare workers and stakeholders.
3. Inadequate Regulation: Inadequate regulation and accreditation of healthcare
providers and services.

10. 4. Corruption: Corruption and mismanagement of healthcare resources.
5. Limited Community Participation: Limited participation of communities and civil
society in health decision-making.
Strategies for Improving Leadership and Governance
1. Strengthening Governance: Strengthening governance structures and processes to
ensure accountability and transparency.
2. Developing Leadership: Developing effective leadership that inspires and motivates
healthcare workers and stakeholders.
3. Improving Regulation: Improving regulation and accreditation of healthcare providers
and services.
4. Promoting Community Participation: Promoting participation of communities and
civil society in health decision-making.
5. Fighting Corruption: Fighting corruption and mismanagement of healthcare
resources.

References

1. World Health Organization. (2010). Everybody's Business: Strengthening Health
Systems to Improve Health Outcomes. WHO Framework for Action.

2. World Health Organization. (2019). Global Strategy on Human Resources for Health:
Workforce 2030. WHO.

3. World Health Organization. (2019). Health Systems Strengthening: Glossary. WHO.

4. World Health Organization. (2017). National Health Systems: Strategies, Challenges,
and Future Directions. WHO.