Many investments in health systems take the form of “health system strengthening” but it is not clear how to rigorously appraise the economic value of such investments. Health interventions often depend on a complex system of human and capital infrastructure that is shared with other interventions, in the form of service delivery platforms. Platforms can be healthcare facilities, hospitals, population-based health interventions or community services. Health system strengthening usually aims to improve the efficiency of such delivery platforms.
This lecture will discuss a typology of ways in which investments in health system strengthening can improve the economic efficiency of health services. Three types of health system strengthening are identified and modelled analytically: (1) investment in quality improvement for an existing shared platform that generates positive benefits across a range of existing interventions; (2) relaxing a capacity constraint for an existing shared platform that inhibits the optimization of existing interventions; (3) providing an entirely new shared platform that supports a number of existing or new interventions. The theoretical models are illustrated with examples. Research results presented in the seminar are part of a paper prepared under the auspices of the International Decision Support Initiative (iDSI), funded by the Gates Foundation, and has involved collaborators from a range of institutions.
Peter C. Smith is a health economist with a particular interest in the financing and efficiency of health systems. He has published extensively on these and related topics, and in recent years his research has focused on the development of universal health coverage in low- and middle-income countries. He has advised the UK government in a number of contexts across the public services, and currently chairs the NHS Advisory Committee on Resource Allocation. He has also advised numerous overseas governments and international agencies, such as WHO, OECD, the European Commission, the World Bank and the IMF.
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Monday, 18 June 2018