Improving the Delivery of Health Services : A Guide to Choosing Strategies

Berman, Peter; Pallas, Sarah; Smith, Amy L.; Curry, Leslie; Bradley, Elizabeth H.

Improving the Delivery of Health Services : A Guide to Choosing Strategies

Autores

Bradley, Elizabeth H.

Editor

World Bank, Washington, DC

Descripción

Sufficient funding and efficacious technology may be necessary conditions for achieving health gains, but experience in many countries confirms that they are not sufficient. Effective and efficient service delivery is the point at which the potential of the health system to improve lives meets the opportunity to realize health gains. Health service delivery performance means access and use by those in need; adequate quality of care to produce health benefits; efficient use of scarce resources; and organizations that can learn, adapt, and improve for the future. All too often, potential benefits are not realized because service delivery underperforms. Organizations must combine financial, physical, and human resources to deliver health services. However, organizations can be complex, and this complexity must be considered in developing strategies for change. This guide will help planners and policy makers navigate the complexity and make better decisions to improve health services. Users of this Guide will find practical advice about what performance means in service delivery as well as how to measure the performance of service delivery organizations. The Guide discusses reforms to service delivery organizations at the system level and at the individual facility level. It emphasizes the internal workings of the organization as well as the external environment in which an organization functions, and discusses its capacity to develop and manage change. A diverse set of theories and concepts explaining organization performance are brought together and compared. Guidance is given on how to identify the root causes of poor performance, the most plausible explanations underlying these causes, and the right strategies to address and improve performance.

Palabras clave

ACCOUNTABILITY, ACCOUNTING, ALLOCATIVE EFFICIENCY, ANTENATAL CARE, ANTENATAL VISITS, ANTICORRUPTION, BEST PRACTICES, CHILD MORTALITY, CHILD SURVIVAL, CHRONIC DISEASE, CIVIL SERVANTS, CLINICAL GUIDELINES, CLINICS, COMMUNITIES, COMMUNITY HEALTH, COMMUNITY HOSPITALS, CORRUPT, CORRUPT PRACTICES, CORRUPTION, DECISION MAKING, DEVELOPING COUNTRIES, DEVELOPMENT ASSISTANCE, DISABILITY, DISADVANTAGED GROUPS, DISCRETION, DISEASES, DISTRICTS, DOCTORS, EFFECTIVE ACTION, EPIDEMIC, EPIDEMICS, EPIDEMIOLOGICAL TRANSITION, ESSENTIAL DRUGS, ETHNIC GROUP, FAMILIES, FAMILY PLANNING, FAMILY PLANNING SERVICES, GENDER, GLOBAL HEALTH, GOVERNMENT CAPACITY, GOVERNMENT OFFICIALS, HEALTH CARE, HEALTH CARE DELIVERY, HEALTH CARE ORGANIZATIONS, HEALTH CARE WORKERS, HEALTH CAREDELIVERY, HEALTH CENTERS, HEALTH DELIVERY, HEALTH EDUCATION, HEALTH FACILITIES, HEALTH FINANCING, HEALTH INFORMATION, HEALTH INFORMATION SYSTEMS, HEALTH MANAGEMENT, HEALTH ORGANIZATION, HEALTH OUTCOMES, HEALTH POLICY, HEALTH PROFESSIONALS, HEALTH PROGRAMS, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE DELIVERY, HEALTH SERVICES, HEALTH SERVICE DELIVERY, HEALTH SERVICEDELIVERY, HEALTH STATUS, HEALTH SYSTEM, HEALTH SYSTEM PERFORMANCE, HEALTH SYSTEM STRENGTHENING, HEALTH SYSTEMS, HEALTH WORKERS, HEALTH WORKFORCE, HIV/AIDS, HOME VISITS, HOSPITAL, HOSPITAL MANAGEMENT, HOSPITAL PATIENTS, HOSPITALS, HOUSEHOLD SURVEYS, HUMAN DEVELOPMENT, HUMAN RESOURCE MANAGEMENT, HUMAN RESOURCES, HUMAN SOCIETIES, IMMUNIZATION, IMMUNIZATIONS, IMPACT ON HEALTH, IMPROVEMENT OF HEALTH, IMPROVING HEALTH CARE, INCOME, INDIVIDUAL HEALTH, INFANT, INFORMATION TECHNOLOGIES, INFORMED DECISIONS, INITIATIVE, INSURANCE, INTERVENTION, INTERVENTIONS, INVESTIGATION, LACK OF KNOWLEDGE, LEADERSHIP, LIVING STANDARDS, MALARIA, MATERIAL RESOURCES, MEDICAL RECORDS, MEDICAL SUPPLIES, MEDICAL TECHNOLOGY, MILLENNIUM DEVELOPMENT GOAL, MILLENNIUM DEVELOPMENT GOALS, MINISTRIES OF HEALTH, MORTALITY, NATIONAL GOVERNMENT, NATIONAL LEVEL, NEEDS ASSESSMENT, NEWBORN, NURSE, NURSES, NURSING, NUTRITION, OCCUPANCY, OCCUPANCY RATES, OCCUPATIONS, ORAL REHYDRATION SOLUTION, PATIENT, PATIENT SATISFACTION, PATIENTS, PEER PRESSURE, PERSONAL HEALTH, PHARMACIES, PLAN OF ACTION, PLANS OF ACTION, POLICY MAKERS, POLITICAL PARTY, POLITICAL POWER, POLITICAL SUPPORT, POPULATION STRATEGY, PRACTITIONERS, PREFERENTIAL, PREGNANT WOMEN, PRIMARY HEALTH CLINIC, PROCUREMENT, PROGRESS, PROVIDER PAYMENT, PSYCHOLOGY, PUBLIC HEALTH, PUBLIC HEALTH PROGRAMS, PUBLIC SERVICE, QUALITY IMPROVEMENT, QUALITY OF CARE, REGULATORY FRAMEWORKS, REMEDY, RURAL AREA, RURAL AREAS, RURAL COMMUNITIES, RURAL COMMUNITY, RURAL HOSPITALS, RURAL POPULATION, SAFETY, SANCTION, SCARCE RESOURCES, SERVICE PROVIDERS, SERVICE PROVISION, SERVICEDELIVERY SYSTEMS, SHOPS, SOCIAL CLASS, SOCIAL NORMS, SOCIAL SCIENCE, SOCIAL SERVICES, SOCIAL SYSTEMS, SOCIETAL LEVEL, SPILLOVER, TRAINING OPPORTUNITIES, TRANSPORTATION, USER FEES, VACCINATION, VILLAGES, WORKERS, WORKING CONDITIONS, WORLD HEALTH ORGANIZATION, YOUNG CHILD, YOUNG CHILDREN