Awareness has grown that international targets, such as the Millennium Development Goals (MDGs) and the provision of antiretroviral treatment for HIV/AIDS patients cannot be achieved without the key elements of a functioning health system. The example of the reduction of maternal mortality in Sri Lanka (chapter 8) demonstrates the improvements in health outcomes that are possible once a basic platform of functioning health services is available on which targeted initiatives can build (Levine 2004).
Thus, the aim of this chapter is to review how health systems can be strengthened in differing country contexts to deliver interventions effectively, efficiently, and equitably. The chapter is mainly concerned with strengthening health services: issues in managing core public health functions are reviewed elsewhere (Khaleghian and Das Gupta 2004). Although the chapter seeks to draw valuable lessons from all parts of the world, it focuses on countries with the least capacity, especially the poorer countries in Sub-Saharan Africa and Asia.
Copyright © 2006, The International Bank for Reconstruction and Development/The World Bank Group.