Session 1
Situating Health Systems Science
Activity 1.1.1
What is Health System Sciences?
Health Systems Sciences is the study of how healthcare is delivered and experienced to provide improved health outcomes that are ethical, equitable, sustainable, and empowering while accounting for the dynamic interrelationships at all biopsychosocial levels.
Why do health systems matter?
Health systems science is important because medical and clinical sciences on their own are not enough to deliver the desired quality of life and health outcomes to citizens. Health systems highlight that the multiple components that make up the health system cannot operate in isolation or separated from the other components. Health systems utilize a systems thinking approach to improve the efficiency quality, equitability and culture of healthcare delivery.
​
​
Why do we have a field of study that focuses on the health system as an object of study?
I think health systems has become an object of study because of the realization that the education in the medical and clinical curriculum has not made a distinct link between the various professional competencies as part of a bigger health system. There has been a growing appreciation of the intersectional influences that impact the outcomes in health systems.
​
​
What is the value of studying Health Systems Science?
I believe studying health systems science is valuable because it provides you with a comprehensive understanding of how multi-directional cause-and-effect relationships emerge because of the effects of other health system dynamics. This allows one to see and address problems from multiple approaches and be cognizant of ecological factors in proposed solutions.
World Health Report 2000 – Health Systems: Improving Performance, 2000 Geneva. World Health Organization.
The role of health systems has become increasingly important to the dramatic rise in life expectancy in the 20th century and has contributed enormously to better health. However, there are enormous gaps between the potential and actual performance of health systems, and there are too many variations in the health outcomes of countries which seem to have the same resources and possibilities.
This report defines a health system to include all the activities whose primary purpose is to promote, restore or maintain health. This would include formal health services, traditional healers, home care for the sick (between 70% to 90% of all sickness is managed), activities that promote health and prevent disease, health intervention such as road and environmental safety improvement, and health-related education – however education its self fall beyond the boundaries of this definition because its primary purpose is not to promote, restore or maintain health. Even though it may be a secondary purpose. This definition of a health system also doesn’t imply any degree of oversight or integration of a health system.
The report suggests that there should be a greater effort to quantify and assess all activities, and related data, related to the wider definition of health systems, so as to gauge their relative cost and effectiveness in contributing to the goals of the system. For example, between 1966 to 1979 the USA introduced a variety of car safety features in the design process which helped to reduce the car accident fatality rate by 40%. All these interventions accounted for only a 2% increase in the average price of a car. Sub-Saharan Africa has the world’s highest rate of fatalities per vehicle.
​
What do Health Systems Do?
Health systems have the responsibility to 1) improve the health of populations they serve with dignity, 2) respond to people’s expectations (the nature of health services should not be determined by providers alone regarding how they are to be treated) and 3) protect people from the financial costs of ill-health.