PHM-Exch> Good Health at Low Cost 25 years on: lessons for the future of health systems strengthening

[Claudio Schuftan]

From: Ruggiero, Mrs. Ana Lucia (WDC) <ruglucia at paho.org>
crossposted from: EQUIDAD at listserv.paho.org


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*Good Health at Low Cost 25 years on:
lessons for the future of health systems strengthening

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Dr Dina Balabanova PhD a , Anne Mills PhD a, Lesong Conteh PhD b, Baktygul
Akkazieva MSc c, Hailom Banteyerga PhD d i, Umakant Dash PhD e,
Lucy Gilson PhD a f, Andrew Harmer PhD g, Ainura Ibraimova PhD c, Ziaul
Islam MSc h, Aklilu Kidanu PhD i, Tracey P Koehlmoos PhD h,
Supon Limwattananon PhD j k, VR Muraleedharan PhD e, Gulgun Murzalieva PhD
l, Benjamin Palafox MSc a, Warisa Panichkriangkrai MPH j,
Walaiporn Patcharanarumol PhD j, Loveday Penn-Kekana MA a, Timothy
Powell-Jackson PhD a, Viroj Tangcharoensathien PhD j, Martin McKee MD a****


*The Lancet, 8 April 2013 doi:10.1016/S0140-6736(12)62000-5Cite or Link
Using DOI*


Website: http://bit.ly/18hYNbo

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“…….In 1985, the Rockefeller Foundation published Good Health at Low Cost
to discuss why some countries or regions achieve better health and social
outcomes than do others at a similar level of income and to show the role
of political will and socially progressive policies. 25 years on, the Good
Health at Low Cost project revisited these places but looked anew at
Bangladesh, Ethiopia, Kyrgyzstan, Thailand, and the Indian state of Tamil
Nadu, which have all either achieved substantial improvements in health or
access to services or implemented innovative health policies relative to
their neighbours.

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 A series of comparative case studies (2009—11) looked at how and why each
region accomplished these changes. Attributes of success included good
governance and political commitment, effective bureaucracies that preserve
institutional memory and can learn from experience, and the ability to
innovate and adapt to resource limitations.

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Furthermore, the capacity to respond to population needs and build
resilience into health systems in the face of political unrest, economic
crises, and natural disasters was important. Transport infrastructure,
female empowerment, and education also played a part. Health systems are
complex and no simple recipe exists for success.

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Yet in the countries and regions studied, progress has been assisted by
institutional stability, with continuity of reforms despite political and
economic turmoil, learning lessons from experience, seizing windows of
opportunity, and ensuring sensitivity to context. These experiences show
that improvements in health can still be achieved in countries with
relatively few resources, though strategic investment is necessary to
address new challenges such as complex chronic diseases and growing
population expectations….”

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