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The results of activities of an organization or investment over a given period of time.

Organizational Performance:◦ A measure of how efficiently and effectively

managers use available resources to satisfy customers and achieve organizational goals.

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A measure of how productively resources are

used to achieve a goal. Organizations are

efficient when managers minimize the

amount of input resources or the amount of

time needed to produce a given output of

goods or services.

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A measure of the appropriateness of the

goals that managers have selected for the

organization and of the degree to which the

organization achieves those goals.

Organizations are effective when managers

choose appropriate goals and then achieve

them.

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The accumulated end results of the

organization's work processes and activities.

Designing strategies, work processes, and

work activities.

Coordinating the work of employees.

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The term Health System Performance Assessment describes a

series of activities including measuring the health system's

contribution to socially desirable goals;

Measuring Measuring the health system and non-health system resources used

to achieve these outcomes;

EstimatingEstimating the efficiency with which the resources are used to attain

these outcomes;

EvaluatingEvaluating the way the functions of the system influence observed

levels of attainment and efficiency;

Designing and implementing Designing and implementing policies to improve attainment and

efficiency and monitoring the effect.

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Importance:

To enable countries to monitor their own

performance and to modify their policies as

necessary it is important to be able to

measure and compare performance over

time.

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WHO's work aims to support the

development of systematic ways to

monitor performance in countries, in a

way that allows comparison across time

within individual systems, across different

levels of a system, and between health

systems.

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To empower decision makersdecision makers, by providing them with reliable information

for policy and system development.

To empower the public,public,with information relevant to their well-being.

 

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The essential concepts underpinning the health system performance framework are:

Health Health System System

FunctionFunctionss

Health Health System System

FunctionFunctionss

Health Health System System GoalsGoals

Health Health System System GoalsGoals

Health Health System System EfficiencEfficienc

y y

Health Health System System EfficiencEfficienc

y y

Health Health System System

BoundariBoundaries es

Health Health System System

BoundariBoundaries es

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The system includes all actors, institutions and

resources that undertake health actions .Four key

functions determine the way inputs are

transformed into outcomes that people value –

resource generation, financing, service provision

and stewardship.

“Health Action”: Any set of activities whose primary

intent is to improve or maintain health

E.g. Seatbelt.

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Health system financing is: the process by which

revenues are collected from primary and

secondary sources.

For the purposes of analysis, it is useful to

subdivide health system financing into three sub-

functions: a) revenue collection, b) fund pooling.c) purchasing.

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Revenue collection refers to the mobilization of money from

primary sources ( individuals, households and firms) and

secondary sources (governments and donor agencies).

Funds can be mobilized through 4 basic mechanisms:

out-of-pocket payments,

General taxation,

Statutory health insurance,

Private health insurance.

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Fund pooling refers to the accumulation of revenues for the

common advantage of participants. Indeed, pooling means

that financial resources in the pool are no longer tied to a

particular contributor. In the language of insurance, pooling

means that contributors share financial risk.

Pooling is distinct from revenue collection as some

mechanisms of revenue collection such as medical savings

accounts do not share financial risks across contributors.

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Purchasing is the process through which revenues that have

been collected and placed in fund pools are allocated to

institutional or individual providers in order to deliver a

specified or unspecified set of interventions.

Purchasing can range from simple budgeting exercises in

highly integrated public systems, where the government

collects revenue through general taxation and allocates it to

programs and facilities for staff and other costs, to more

complicated strategies where specified units of inputs,

outputs or outcomes are purchased

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This function refers to the combination of inputs into a

production process that takes place in a particular

organizational setting and that leads to the delivery of a

series of interventions.

In analyzing provision, it is useful to keep in mind the

conventional distinction between personal and non-

personal health services.

personal health services: refer to services that are

consumed directly by an individual, whether they are

preventive, diagnostic, therapeutic, or rehabilitative.

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non-personal health services: refer to actions that are

applied either to collectivities (e.g., mass health education)

or to the non-human components of the environment (e.g.,

basic sanitation).

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Health systems are not limited to the set of institutions that

finance or provide services, but include a diverse group of

organizations that produce inputs to those services,

particularly human resources, physical resources such

as facilities and equipment, and knowledge. This set of

organizations encompasses universities and other

educational institutions, research centers, construction

firms, and the vast array of organizations producing

specific technologies such as pharmaceutical products,

devices and equipment.

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A neglected function in most health systems, stewardship goes

beyond the conventional notion of regulation. It involves three

key aspects: setting, implementing and monitoring the rules of

the game for the health system; assuring a level playing field

among all actors in the system (particularly purchasers, providers

and patients); and defining strategic directions for the health

system as a whole. In order to deal with these aspects,

stewardship can be subdivided into six sub-functions: overall

system design, performance assessment, priority setting,

intersectional advocacy, regulation and

consumer protection.

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Health systems with the same level of

resources can achieve very different results.

The WHO framework proposes a way of

examining how well a health system is

doing, given the resources available to it

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