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Strengthening health
systems: focus on people
Zsuzsanna Jakab
WHO Regional Director
for Europe
16 December 2014, Malta
Burden of noncommunicable diseases,
including in Malta
Rank and disorder, 1990 Rank and disorder, 2010
Sou
rce:
GB
D 2
010,
IHM
E
Need for population-based
interventions
So
urc
e: W
HO
NH
A d
ata
20
14
0
5
10
15
20
25
30
35
40
45
EU pre-2004
EU EU post-2004
EuropeanRegion
Malta CIS
2001 2011
Rising out-of-pocket expenditurefurther
exacerbates health inequalities
EU: European Union
CIS: Commonwealth of Independent States
0
10
20
30
40
50
60
70
Male Female Both
Overall, a changing health landscape
… and health systems?
HEALTH
SYSTEM
TECHNOLOGIES
MODEL OF CARE
INFORMATICS
FINANCING
PUBLIC-PRIVATE
PARTNERSHIPS
WORKFORCE
MEDICINES
HEALTH
SYSTEM
Innovation in health systems has proved
effective in tackling these challenges
Health 2020: people-centred
health systems
Universal health coverage
Accountable whole-of-government and society
Financial
protection
Competencies
Intersectoral
actions and
public health
Integrated
people-
centred
services
Information Innovations
People
Health system strengthening
for NCD management
Primary health
care/Public health
Ireland Republic of MoldovaBelgiumIsrael
TurkeySpain DenmarkKazakhstanUniversal health
coverage
Integrated
care
Health systems
performance
assessment
Mobility of
health care
workers
Governance for
health
Partnership
Progress in health systems
NCDs: noncommunicable diseases
Transforming towards people-centred health and
public health services: subnational initiatives
Northern Ireland: creating 17 integrated care partnerships
(Transforming Your Care initiative)
Scotland: new approaches that build and reinforce
accountable delivery so the interventions pursued are appropriately integrated,
aligned and managed
Basque Country: new models of care to create coordinated
“local systems of care” as new policy environment for local
coordination (Basque Chronicity Strategy)
Catalonia: network for the provision of services
Improved outcomes for NCDs through
strengthening health systems
Planning and
Implementation
Networks and
clusters
Intersectoral
interventions
Chronic disease
management
Health and wellness
management
Care across the life
cycle
Health promotion and
disease prevention
Extended diagnostic
services
Community-based
health care
Home care
palliative care
Mental health
Acute demand-led
services
Accident and
emergency
Community hospitals
Community
pharmacies
Call-in centres
Primary health care has proved a successful
approach to improve access
Eliminate ineffective and inappropriate services
Improve rational use of medicines
Allocate more to public health, primary and outpatient specialist care at the
expense of hospital care
Invest in infrastructure that is less costly to run – “invest to save”
Cut the volume of least cost-effective services
Focus on health systems’ performance
Malta secures health system
for future generations
Enabling a competent health workforce
Innovating medicines and technology
Generating health intelligence
Managing change and innovation
Transforming health service delivery
Walking the talk on people-centredness
Moving towards universal health coverage
Priorities for strengthening a value-
driven health system
Thank you!
See the WHO Regional Office for Europe website
(http://www.euro.who.int/en/home) for further information