OVERVIEW day and every day, the lives of vast numbers of people lie in the hands of health systems. From the safe delivery of a healthy baby to the care with dignity of the frail elderly, health systems have a vital and continuing responsibility to people throughou the lifespan. They are crucial to the healthy development of individuals, families and socie- ties everywhere In this report, health systems are defined as comprising all the organizations, institu ns and resources that are devoted to producing health actions. a health action is defined as any effort, whetherin personal health care, public health services or through intersectoral initiatives, whose primary purpose is to improve health. But while improving health is clearly the main objective of a health system, it is not the only one. The objective of good health itself is really twofold: the best attainable average level - goodness-and the smallest feasible differences among individuals and groups faimess. Goodness means a health system responding well to what people expect of it; fairness it responds equally well to everyone, without discrimination. In The world health report 2000, devoted entirely to health systems, the World Health Organization ex- pands its traditional concen for people,'s physical and mental well-being to emphasize these other elements of goodness and fairness To an unprecedented degree, it takes account of the roles people have as providers and consumers of health services, as financial contributors to health systems, as workers within them, and as citizens engaged in the responsible management, or stewardship, of them And it looks at how well or how badly systems address inequalities, how they respond people' s expectations, and how much or how little they respect people's dignity, rights and The world health report 2000 also breaks new ground in presenting for the first time an dex of national health systems performance in trying to achieve three overall goals: goo health, responsiveness to the expectations of the population, and faimess of financial contribution Progress towards them depends crucially on how well systems carry out four vital func tions. These are: service provision, resource generation, financing and stewardship. The report devotes a chapter to each function, and reaches conclusions and makes policy recommen dations on each. It places special emphasis on stewardship, which has a profound influence the other three Many questions about health system performance have no clear or simple answers because outcomes are hard to measure and it is hard to disentangle the health system's contribution from other factors. Building on valuable previous work, this report introduces WHOs framework for assessing health system performance. ByOverview xi OVERVIEW  oday and every day, the lives of vast numbers of people lie in the hands of health systems. From the safe delivery of a healthy baby to the care with dignity of the frail elderly, health systems have a vital and continuing responsibility to people throughout the lifespan. They are crucial to the healthy development of individuals, families and socie￾ties everywhere. In this report, health systems are defined as comprising all the organizations, institu￾tions and resources that are devoted to producing health actions. A health action is defined as any effort, whether in personal health care, public health services or through intersectoral initiatives, whose primary purpose is to improve health. But while improving health is clearly the main objective of a health system, it is not the only one. The objective of good health itself is really twofold: the best attainable average level – goodness – and the smallest feasible differences among individuals and groups – fairness. Goodness means a health system responding well to what people expect of it; fairness means it responds equally well to everyone, without discrimination. In The world health report 2000, devoted entirely to health systems, the World Health Organization ex￾pands its traditional concern for people’s physical and mental well-being to emphasize these other elements of goodness and fairness. To an unprecedented degree, it takes account of the roles people have as providers and consumers of health services, as financial contributors to health systems, as workers within them, and as citizens engaged in the responsible management, or stewardship, of them. And it looks at how well or how badly systems address inequalities, how they respond to people’s expectations, and how much or how little they respect people’s dignity, rights and freedoms. The world health report 2000 also breaks new ground in presenting for the first time an index of national health systems’ performance in trying to achieve three overall goals: good health, responsiveness to the expectations of the population, and fairness of financial contribution. Progress towards them depends crucially on how well systems carry out four vital func￾tions. These are: service provision, resource generation, financing and stewardship. The report devotes a chapter to each function, and reaches conclusions and makes policy recommen￾dations on each. It places special emphasis on stewardship, which has a profound influence on the other three. Many questions about health system performance have no clear or simple answers – because outcomes are hard to measure and it is hard to disentangle the health system’s contribution from other factors. Building on valuable previous work, this report introduces WHO’s framework for assessing health system performance. By clarifying and quantifying