By Hira Zubair
Health systems are complex and diverse, reflecting the societies they serve. It’s difficult to define them precisely, but the World Health Report 2000 offers a widely accepted definition: health systems include all institutions, actors, and activities aimed at promoting, restoring, or maintaining health.
As the demand for better healthcare grows globally, so does the need for health system reforms to meet people’s expectations. The challenges include lack of political will and funding prioritization, particularly in low- and middle-income countries (L&MICs).
Over the last 25 years, there has been an increasing focus on health systems in policy discussions, leading to the development of health system studies as an academic discipline. Various agencies, including the WHO, World Bank, and USAID, have produced reports and manuals on health systems, while scholars like Roemer, Kleczkowiski, Elling, Soucat, Paina, Scott, Kielman, and Smith have contributed to understanding the subject. In 2016, the WHO released the Handbook “Strategising National Health in the 21st Century.”
The latest milestone in health system literature is the “Making Health Systems Work in Low and Middle-Income Countries: Textbook for Public Health Practitioners.” This is the first comprehensive textbook on the topic, led by Pakistani health system scholar Sameen Siddiqi. The project is a result of global collaboration, with contributors from various countries.
The textbook covers a wide range of essential aspects of healthcare systems, aiming to bridge the gap between theory and practice to strengthen health systems. It consists of 37 chapters, organized into two sections. The first section, “Analysing Health Systems: Concepts, Components, Performance,” comprises 14 chapters, addressing conceptual frameworks, primary health care (PHC), universal health coverage (UHC), and all building blocks of the health system, including governance, financing, health workforce, pharmaceutical system and regulation, health information system, health services, community engagement, attributes of the health system, assessment approaches, decision-making tools, and health system research.
The book serves as a valuable resource for public health practitioners, providing in-depth insights into health systems and offering strategies to improve their performance. With contributions from experts worldwide, it reflects the global effort to enhance healthcare systems and ultimately improve health outcomes for all.
A groundbreaking textbook on health systems is making waves worldwide with its comprehensive approach to transforming healthcare. The second section of the book, titled “Transforming Health Systems: Confronting Challenges, Seizing Opportunities,” comprises 23 chapters covering essential topics such as universal health coverage (UHC), pro-poor health financing, health insurance, strategic purchasing, good governance, health workforce development, access to medicines and health technologies, data-driven decision-making, and more.
Impressively, the book boasts contributions from around 100 authors representing 36 countries, making it a monumental effort to bring together diverse concepts, global perspectives, experiences, and practices aimed at strengthening health systems in low- and middle-income countries (L&MICs). With approximately 70 text boxes featuring national examples, the book offers a wealth of knowledge and insights.
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Esteemed figures in the global health community, including Julio Frank, president of the University of Miami, Anutin Charnvirakul, deputy prime minister of Thailand, Mamta Murti, vice president for Human Development at the World Bank, and Dr. Ahmad Al Mandhari, WHO regional director for the Eastern Mediterranean, have given their superlative endorsements to this magnum opus.
Upon its release as the first-ever textbook on health systems, the global health community warmly embraced it. The book was launched simultaneously in multiple cities, including Karachi, Cairo, Cambridge, Toronto, and Houston, in January 2023. Published by Cambridge University Press, the book is available in paperback to keep costs down, but it remains expensive for many in L&MICs. However, negotiations for special prices on bulk purchases could be an option for these countries.
The book’s potential impact has already garnered significant attention globally, yet its reception in Pakistan has been relatively muted. Given the critical importance of strengthening health systems in Pakistan, this book presents a unique opportunity for the country. Led by Dr. Sameen Siddiqi, a highly respected health system specialist from Pakistan, the book is a source of national pride.
However, beyond the academic circle at the Aga Khan University, the local public health community is largely unaware of the book’s significance. To bridge this gap, libraries and health institutions should consider obtaining the e-version of the book for easy access by students and faculty. Investing in a copy of the textbook promises substantial returns in enhancing healthcare in Pakistan.
In conclusion, the “Making Health Systems Work in Low and Middle-Income Countries: Textbook for Public Health Practitioners” is a revolutionary resource that seeks to transform healthcare systems globally. Its comprehensive approach and expert contributors make it an invaluable tool in the ongoing effort to improve health systems worldwide.
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