Decision-making and health system strengthening: bringing time frames into perspective.
Health Policy Plan
; 35(9): 1254-1261, 2020 Nov 20.
Article
em En
| MEDLINE
| ID: mdl-33450766
ABSTRACT
In many low-and middle-income countries, health systems decision-makers are facing a host of new challenges and competing priorities. They must not only plan and implement as they used to do but also deal with discontented citizens and health staff, be responsive and accountable. This contributes to create new political hazards susceptible to disrupt the whole execution of health plans. The starting point of this article is the observation by the first author of the limitations of the building-blocks framework to structure decision-making as for strengthening of the Moroccan health system. The management of a health system is affected by different temporalities, the recognition of which allows a more realistic analysis of the obstacles and successes of health system strengthening approaches. Inspired by practice and enriched thanks a consultation of the literature, our analytical framework revolves around five dynamics the services dynamic, the programming dynamic, the political dynamic, the reform dynamic and the capacity-building dynamic. These five dynamics are differentiated by their temporalities, their profile, the role of their actors and the nature of their activities. The Moroccan experience suggests that it is possible to strengthen health systems by opening up the analysis of temporalities, which affects both decision-making processes and the dynamics of functioning of health systems.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Tempo
/
Tomada de Decisões
/
Planos de Sistemas de Saúde
Limite:
Humans
Idioma:
En
Revista:
Health Policy Plan
Assunto da revista:
PESQUISA EM SERVICOS DE SAUDE
/
SAUDE PUBLICA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Marrocos