Need to move from WHO’s Health Systems Framework to Health Outcome Framework for Sustainable Improvement in Health

Health Systems Framework to Health Outcome Framework

Abstract

The WHO health System Framework has been used since 2007.  Though useful in assessing and measuring the six building blocks of health systems and progress over a period of time in a country and comparing with other countries. However, it does not capture patients, families and communities who are the most important stakeholders in health care. It does not take into account the social determinants of health. There is a need to adopt a health outcome framework which addresses all social determinants of health including beneficiaries, their families and community in addition to the health system. The families are the most important players in health as it is family and community where health is ‘produced’ and often diseases start there. The beneficiaries approach health system when their health breaks down and for some preventive services. The authors propose a health outcome framework adapted from World Bank’s health outcome framework. The proposed framework with inclusion of family and community level aspects and social determinants of health is needed. It is more comprehensive as it also includes the building blocks of WHO’s current health systems framework. The authors recommend health outcome framework for use in place of WHO’s health system framework to address all the determinants of health to improve health outcome in a population.