Description
This presentation by Margarate N. Munakampe, adapted from the work of Lucy Gilson, provides a foundational analysis of policy actors and the dynamics of power within health policy and management. It systematically identifies and categorises key actors from both inside and outside the bureaucracy, including authorisers, interest groups, the media, citizens, beneficiaries, and street-level bureaucrats. The material explores how actors' interests, values, and beliefs shape their engagement with policy, and examines the multiple forms of power they wield, from overt decision-making to covert resistance and thought control. This resource is essential for students enrolled in tertiary programmes such as Master of Public Health, Health Systems Management, or Health Policy, offering critical insights for analysing stakeholder influence and navigating the political dimensions of health system reform. It equips learners with the conceptual tools to assess actor networks and power sources in real-world policy implementation. Use this analysis to deepen your understanding of the actors who shape health policy outcomes.
What's inside
What is a health system? ICHS 2 www.hpsa-africa.org @hpsa_africa www.slideshare.net/hpsa_africa Introduction to Complex Health Systems Outline Definition of health system Conceptual frameworks that help think about health systems as basis for action Key social goal… Improve health by average level of population health health inequities Health systems “All organizations, people and action whose primary intent is to promote, restore or maintain health” WHO, 2007 http://www.who.int/healthsystems/strategy/en/ Health System Health Beyond sickness mental & physical health social wellbeing Beyond the individual all agents promoting health & wellbeing domestic/national AND international factors impacting on health and HS agents A system is any collection of related parts that interact in an organized way for a purpose Starting points: What are the basic building blocks? What is a health system? It is the sum of all the organizations, institutions and resources whose primary purpose is to improve health. A health system needs staff, funds, information, supplies, transport, communications and overall guidance and direction. And it needs to provide services that are responsive and financially fair, while treating people decently. Growing recognition Overall, there is a growing recognition that to maintain and improve the health of the world’s people governments must shape sound, efficient health systems that provide effective disease prevention and treatment to all women, men and children, no matter who they are or where they live. 1. Stewardship Stewardship, sometimes more narrowly defined as governance, refers to the wide range of functions carried out by governments as they seek to achieve national health policy objectives. 2. Financing The purpose of health financing is to ensure that adequate funding is available and the right financial incentives are in place to guarantee that all individuals have access to needed preventive and personal health care. 3. Workforce The performance of health care systems depends on the knowledge, skills, motivation and distribution of the people responsible for organizing and delivering services. 4. Information Accountability, resource allocation, programme improvement and management decisions all rely on sound health information 5. Drugs and technology The availability, quality, efficacy, safety and rational use of drugs and health technology are necessary for effective health service delivery. 6. Service delivery Just as the principal objective of a health system is to improve people's health, the chief function the system needs to perform is to deliver health services. WHO, 2007 Caveat – no easy answers to how to improve a health system! politics and values matter….
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