A systems framework for healthy policy

This health policy framework builds on the World Health Organization (WHO) Health Systems Framework. The WHO Framework focuses on systems and services for treatment. It also addresses issues of sustainability, NCDs, health protection and public health. The health policy framework described here provides more detailed information on services and communication and also in addressing gaps and challenges identified in the WHO framework and other models. The framework therefore takes not only a systems-strengthening approach but also a public health approach.

Vision

This framework seeks to advance global health security and sustainable well-being for all.

Objectives of the framework

  • To strengthen health systems’ ability to implement universal health coverage (UHC) by facilitating global health security and sustainable, fair health outcomes.
  • To support wider economic growth and the post-2015 Sustainable development Goals (SDGs)
  • To provide a flexible policy framework for tools that can be applied to different countries and settings to strengthen health systems, including for assessment, planning, training, evaluation and accreditation.
  • To strengthen leadership and governance, scale up workforce planning and public health capacity-building, standardise assessment and improve the quality of health systems.

The systems framework for healthy policy is intended to provide a high- level comprehensive overview of the main policy components for health system strengthening. It includes 8 components as seen in the diagram below and is overarching, allowing for the development of more specific tools to link into each component.

The summary graphic illustrates the main relationships between each heading and relevant sub-headings.Systems framework

Governance: public health legislation; policy; strategy; financing; organisation; quality assurance: transparency, accountability and audit.

Knowledge: surveillance, monitoring and evaluation; research and evidence; risk and innovation; dissemination and uptake.

Protection: IHR and co-ordination; communicable disease control; emergency preparedness; environmental health; climate change and sustainability.

Promotion: inequalities; environmental determinants; social and economic determinants; resilience; behaviour and health literacy; life-course; healthy settings.

Prevention: primary prevention: vaccination; secondary prevention: screening; healthcare management and planning.

People: primary health care; secondary health care; tertiary health care and rehabilitation.

Advocacy: leadership and ethics; community engagement and empowerment; communications; sustainable development.

Capacity: workforce development for public health, health workers and wider workforce; workforce planning: numbers, resources, infrastructure; standards, curriculum, accreditation; capabilities, teaching and training.

The framework can be used as a flexible assessment, planning and evaluation tool for policy-making to enable the delivery of UHC. The structure of the health systems framework is being used to develop a series of more detailed policy toolkits, including a health protection policy toolkit. In addition, a series of supportive policy briefs are being developed on more specific areas.

Development

The origins of this systems framework for health policy began with the Director-General of the WHO requesting that the World Federation of Public Health Associations (WFPHA), develop a response to address the multiple and complex public health challenges. As a part of the response, it was recognised that one of the obstacles to addressing these challenges was the lack of a clear understanding, standards or consensus on public health services, operations and functions and gaps in the WHO framework. Therefore, this systems framework for healthy policy aims to build upon current knowledge while addressing these issues. It applies existing models for health system strengthening, including country- and regional level public health functions and operations from the WHO Pan American Health Organization (PAHO) and the WHO regional Office for Europe (WHO EURO), as well as from the USA, the UK, Australia and Canada. The framework aims to bring together the best of all the existing models and provide a comprehensive, clear and flexible approach that can be applied within individual countries, whether in a low-, middle- or high-income setting.