Health systems – their organisation and financing – are areas that are receiving unprecedented attention and scrutiny.
In recent months the launch of the International Health Partnership has reoriented international donors’ attention to the need to harmonise their efforts to support recipient country health plans. The mid-point of the Millennium Development Goals has focussed attention on maternal, newborn and child health: the progress made towards international targets and the way in which services to meet the health needs of women and children are organised. The 30th anniversary of the Alma-Ata Declaration promises an assessment of political commitment to primary health care.
This special issue of Social Science and Medicine argues that dominant discourse in international organisations and academic journals about health systems and health system organisation derives largely from the experience of a few advanced market economies. This diverts attention from innovations that are emerging in other countries in response to pressures from radical economic, social, institutional and political change.
Much discussion about the options for global health system reform refers to “scaling up” and “rolling out” of cost-effective interventions, suggesting that organisational arrangements for spreading access to the benefits of medical knowledge are unproblematic except for resource constraints.
This issue explores health systems as knowledge economies. As ways of organising access to expert knowledge or expertise embodied in both people and products, and in which multiple types of power relations are embedded. This way of conceptualising health systems enables us to ask fundamental questions about the changing nature of expertise, how it is held or withheld, who gains access to it and the different ways it can be organised.
Read more in our flyer.
The special issue was covered on the USAID Health Systems 20/20 blog