2. SPECIFIC Objectives
BY the end of this course, the student will be able to:
Describe the roles of hospital and health centers
Discuss public/private partnership
Discuss equity of access in health service delivery
Describe the priority setting in health
3. Course Content
Overview
Roles of the hospitals and health
centers
Public/private provision of health
services
Equity in health services delivery
Priority setting in health
4. Overview
A well functioning health system
working in harmony is built on having
trained motivated health workers a
well maintained infrastructure and a
reliable supply of medicines and
technologies backed by adequate
funding strong health plans and
evidenced based policies
5. Overview (1)
Mission Statement: To provide
equitable access to cost effective,
quality health services as close to
the family as possible
Efficient and Effective health
service delivery
Reliable, transparent and
acceptable governance systems and
structures
6. Overview (2)
Reliable, timely and comprehensive
information systems
Adequate infrastructure, medical
equipment and other technologies
Competent health workers at the
point of services delivery
Stable predictable and equitable
financing
7. Overview 3
Service delivery is when the inputs are organized
and managed to ensure improved access to
services
Delivery of health services should have an impact
on peoples health
People should be covered by a broad spectrum of
health services from preventive health services to
curative services, rehabilitative services and
palliative care for peoples ends of lives
Ensuring services are of good quality, safe for
people to consume including continuity of care
across services as people interact with the health
system
8. Delivery of Health Care
Services
Basic essential
health care package
at each level of
care in order to
achieve WHO three
major goals
9. Roles of health centres
Health centre (primary level) the first contact level where people
first interact with the overall health system
WHO and many world public health emphasizes the vital
importance of primary health care in improving health centers
Essential health care based on values of universal access, equity,
participation and intersectoral action, working with other sectors
that impact on health
10. Roles of District Health Office
Primary management unit in the decentralised
health system
Administer the affairs of the district health
services
Responsible for planning for the district
Responsible for ensuring that local priorities are
recognised and addressed
Responsible for coordinating with other sectors
e.g. agriculture, local government, etc.
Responsible for monitoring performance of HCs
and level 1 hospitals against established standards
Responsible for providing training to district staff
11. Roles of Hospitals(2)
Hospitals have certain unique roles and attributes
The improvement of community health status
The integral relationship of the hospital within
the community
Access to care for those in need of services
The obligation to provide high quality health care
services
Recognition that public expectations from non
profit and public hospitals are unique
The importance of fiscal responsibility in ensuring
the long-term commitment of hospitals to their
communities
12. Roles of hospitals(3)
The maintenance of traditional values of
compassion and charity
Voluntary governance and accountability to the
community. The governing body of the hospital
provides the critical linkage between the values of
the community and the day-to-day operations of a
complex health organization
The physician-hospital relationship - The
leadership and hospital management work in
partnership with the medical staff to create the
delicate and vital balance between institutional
imperatives and professional
13. Private/Public Health
services
The health sector in Zambia is liberalised and
embraces diversity in ownership, including:
Public health sector - health facilities and
programmes under the MOH, and some government
line ministries and departments;
Faith-based health sector, under the coordination
of CHAZ;
Private sector: for- and not-for profit health
services, owned by private investors and Civil
Society Organisations (CSOs);
Traditional and alternative health service
providers,
ALL operate informally and are not regulated or
monitored by MOH.
14. Equity in health services
Mission Statement:To provide equitable access to cost effective,
quality health services as close to the family as possible
Vision: To improve the health status of people in Zambia in order to
contribute to socio-economic development
Key Principles: Primary Health Care (PHC) approach; Equity of access;
Affordability; Cost-effectiveness; Accountability; Partnerships;
Decentralisation and Leadership; Clean, Caring and Competent health
care environment
15. Equity in Health Services(2)
Efforts aimed to improve access to health services are:
Abolition of user fees in 54 rural districts,
Construction and renovation of health facilities
across the country,
Investments in medical equipment and transport,
Availability of essential drugs and medical supplies
Scaling up of outreach health services
Health promotion and education
Equities in income levels at household level.
16. Priority setting in Health
1.Public Health Priorities :
Primary health care services.
Maternal, neonatal and child health.
Communicable diseases, especially malaria, HIV and
AIDS, STIs and TB.
Non-Communicable Diseases (NCDs).
Epidemics control and public health surveillance.
Environmental health and food safety.
Health service referral systems.
Health promotion and education
17. Priority Setting in Health (2)
2.Health System Priorities:
Human Resources for Health (HRH).
Essential drugs and medical supplies.
Infrastructure and Equipment.
Health information.
Health care financing.
Health Systems Governance
18. CONCLUSION
Health service delivery and improving services = quality of services
Measuring out patient attendance or deliveries of babies in health
units is not good enough.
Services will only have an impact on peoples health if they are
efficient ,effective, safe and good quality health care
Measuring the quality of service involves; technical quality, medicines
work and consumer’s perceptions (treated with dignity, seen on time,
friendly)
