Book contents
- Making Health Systems Work in Low and Middle Income Countries
- Reviews
- Making Health Systems Work in Low and Middle Income Countries
- Copyright page
- Dedication
- Contents
- About the Editors
- Contributors
- Preface
- Section 1 Analyzing Health Systems: Concepts, Components, Performance
- Section 2 Transforming Health Systems: Confronting Challenges, Seizing Opportunities
- Chapter 15 Universal Health Coverage and Beyond
- Chapter 16 Pro-Poor Expansion of Universal Health Coverage
- Chapter 17 Health Insurance for Advancing Universal Health Coverage
- Chapter 18 From Passive to Strategic Purchasing in Low and Middle Income Countries
- Chapter 19 Good Governance and Leadership for Better Health Systems
- Chapter 20 Developing a Balanced Health Workforce
- Chapter 21 Enhancing Equitable Access to Essential Medicines and Health Technologies
- Chapter 22 Health Information and Information Technology
- Chapter 23 Using Health Research for Evidence-Informed Decisions in Health Systems in L&MICs
- Chapter 24 Integrated People-Centered Health Care
- Chapter 25 Strengthening Hospital Governance and Management to Become High-Performing Organizations
- Chapter 26 Improving the Quality and Safety of Health Care in Low and Middle Income Countries
- Chapter 27 Harnessing the Contribution of the Private Health Care Sector toward Public Health Goals
- Chapter 28 Public–Private Partnership in Health Care Services
- Chapter 29 Embedding People’s Voice and Ensuring Participatory Governance
- Chapter 30 Achieving Health-Related Sustainable Development Goals
- Chapter 31 The Determinants of Health Systems
- Chapter 32 Integrating Essential Public Health Functions in Health Systems
- Chapter 33 Engaging in a Health Care Recovery Process
- Chapter 34 Health System Response to the COVID-19 Pandemic
- Chapter 35 Understanding the Global Health Architecture
- Chapter 36 Political Economy of Health Reforms in Low and Middle Income Countries
- Chapter 37 Better Health Systems for Better Outcomes
- Index
- References
Chapter 31 - The Determinants of Health Systems
Upstream Approach to Addressing Health and Social Inequities
from Section 2 - Transforming Health Systems: Confronting Challenges, Seizing Opportunities
Published online by Cambridge University Press: 08 December 2022
- Making Health Systems Work in Low and Middle Income Countries
- Reviews
- Making Health Systems Work in Low and Middle Income Countries
- Copyright page
- Dedication
- Contents
- About the Editors
- Contributors
- Preface
- Section 1 Analyzing Health Systems: Concepts, Components, Performance
- Section 2 Transforming Health Systems: Confronting Challenges, Seizing Opportunities
- Chapter 15 Universal Health Coverage and Beyond
- Chapter 16 Pro-Poor Expansion of Universal Health Coverage
- Chapter 17 Health Insurance for Advancing Universal Health Coverage
- Chapter 18 From Passive to Strategic Purchasing in Low and Middle Income Countries
- Chapter 19 Good Governance and Leadership for Better Health Systems
- Chapter 20 Developing a Balanced Health Workforce
- Chapter 21 Enhancing Equitable Access to Essential Medicines and Health Technologies
- Chapter 22 Health Information and Information Technology
- Chapter 23 Using Health Research for Evidence-Informed Decisions in Health Systems in L&MICs
- Chapter 24 Integrated People-Centered Health Care
- Chapter 25 Strengthening Hospital Governance and Management to Become High-Performing Organizations
- Chapter 26 Improving the Quality and Safety of Health Care in Low and Middle Income Countries
- Chapter 27 Harnessing the Contribution of the Private Health Care Sector toward Public Health Goals
- Chapter 28 Public–Private Partnership in Health Care Services
- Chapter 29 Embedding People’s Voice and Ensuring Participatory Governance
- Chapter 30 Achieving Health-Related Sustainable Development Goals
- Chapter 31 The Determinants of Health Systems
- Chapter 32 Integrating Essential Public Health Functions in Health Systems
- Chapter 33 Engaging in a Health Care Recovery Process
- Chapter 34 Health System Response to the COVID-19 Pandemic
- Chapter 35 Understanding the Global Health Architecture
- Chapter 36 Political Economy of Health Reforms in Low and Middle Income Countries
- Chapter 37 Better Health Systems for Better Outcomes
- Index
- References
Summary
Just as there are determinants of health of individuals and communities, there are determinants of health system organization and performance which we term structural determinants. This chapter focuses on a set of such determinants considered key in understanding and strengthening health systems in low- and middle-income countries (L&MICs). These determinants include politics and governance; the economy, livelihoods and poverty; climate change, environmental degradation and natural disasters; social and organizational culture; wars and conflicts. Each of these determinants has its own set of issues. For example, with regards to politics and governance, it is intersection of the form of authority, institutional arrangements, political values, citizen participation, corruption, and informal governance channels that determine health system performance. While the influence of structural determinants on health systems is acknowledged, there is still limited attention to integrating work on structural determinants in health system thinking, policies and practice. This chapter argues for a multi-pronged strategy to address this gap: focusing on tackling inequities; removing misconceptions about health determinants among health workers; easing the path to health system work on health determinants; engaging concerned communities; evaluating innovations to address health determinants; and strengthening intersectoral collaboration.
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- Making Health Systems Work in Low and Middle Income CountriesTextbook for Public Health Practitioners, pp. 479 - 495Publisher: Cambridge University PressPrint publication year: 2022