Health Systems principled integrated care Confronting the global health challenges examined in the previous chapters requires health systems to be strengthened. Without this, the health goals described in this report will remain beyond reach. The lessons learnt from past successes, including the skills and strategies developed from the experiences of tackling polio and SARS, must be applied in combating the HIVIAIDS treatment emergency and in working towards the Millennium Development Goals(MDGs). Progress towards these and other objectives will not be sustainable unless specific health targets- including the 3 by 5 target of reaching three million people developing countries with combination antiretroviral therapy for HIviaidS by the end of 2005-support a broad horizontal build-up of the capacities of health systems Despite the health reforms of recent decades, inadequate progress has been made in building health systems that promote collective health improvement. Now, however, fresh opportuni ies are emerging. Health stands high on the international development agenda, and new funds are becoming available for health work in poor countries. Extending health-enabling conditions and quality care to all is the major imperative for health systems. This chapter explores how the values and practices of primary health care, adapted to the realities of today's complex health landscape, might provide a basis for the improvement of health systems. It reviews basic ideas about primary health care and clarifies the concept of the development of health systems that are based on primary health care. It then examines four major challenges facing health systems: the global health workforce crisis; the lack of appropriate, timely evidence; the lack of financial resources; and the stewardship challenge of implementing pro-equity health policies in a pluralistic environment. The final section looks at how WHO is working with countries to clarify health systems goals and to strengthen systems in line with primary health care principle The health system comprises all organizations, institutions and resources that produce ac tions whose primary purpose is to improve health(1). The health care system refers to the institutions, people and resources involved in delivering health care to individuals. This chapter is mostly concerned with health care systems. Nevertheless, health care providers are often involved in promoting health-enabling conditions in the community. Indeed, this relation- ship between patient care and public health functions is one of the defining characteristics of the primary health care approach The health systems performance assessment framework developed by WHO in the late 1990s was an attempt to put into effect the primary health care concern for equity and population health outcomes, by providing analytical tools to translate these concerns into relevantHealth Systems: principled integrated care 105 7 Health Systems: principled integrated care Confronting the global health challenges examined in the previous chapters requires health systems to be strengthened. Without this, the health goals described in this report will remain beyond reach. The lessons learnt from past successes, including the skills and strategies developed from the experiences of tackling polio and SARS, must be applied in combating the HIV/AIDS treatment emergency and in working towards the Millennium Development Goals (MDGs). Progress towards these and other objectives will not be sustainable unless specific health targets – including the “3 by 5” target of reaching three million people in developing countries with combination antiretroviral therapy for HIV/AIDS by the end of 2005 – support a broad horizontal build-up of the capacities of health systems. Despite the health reforms of recent decades, inadequate progress has been made in building health systems that promote collective health improvement. Now, however, fresh opportuni￾ties are emerging. Health stands high on the international development agenda, and new funds are becoming available for health work in poor countries. Extending health-enabling conditions and quality care to all is the major imperative for health systems. This chapter explores how the values and practices of primary health care, adapted to the realities of today’s complex health landscape, might provide a basis for the improvement of health systems. It reviews basic ideas about primary health care and clarifies the concept of the development of health systems that are based on primary health care. It then examines four major challenges facing health systems: the global health workforce crisis; the lack of appropriate, timely evidence; the lack of financial resources; and the stewardship challenge of implementing pro-equity health policies in a pluralistic environment. The final section looks at how WHO is working with countries to clarify health systems goals and to strengthen systems in line with primary health care principles. The health system comprises all organizations, institutions and resources that produce ac￾tions whose primary purpose is to improve health (1). The health care system refers to the institutions, people and resources involved in delivering health care to individuals. This chapter is mostly concerned with health care systems. Nevertheless, health care providers are often involved in promoting health-enabling conditions in the community. Indeed, this relation￾ship between patient care and public health functions is one of the defining characteristics of the primary health care approach. The health systems performance assessment framework developed by WHO in the late 1990s was an attempt to put into effect the primary health care concern for equity and population health outcomes, by providing analytical tools to translate these concerns into relevant