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Frameworks

The first step to analysis of health system performance involves outlining what the health system is, what its goals are, and the tools it has at its disposal to achieve these goals. This can be done using a conceptual framework. A good place to start is by looking at existing international frameworks which are often adapted for national settings.

This page is devoted to the collection and presentation of various international frameworks to assist policy makers and researchers in the study, search or comparison of know-how in this area.

 

Frameworks Table

FrameworkGeneral DescriptionSource
EuroREACH Framework The EuroREACH framework is based on the OECD HCQI framework highlighting the importance of quality of health care within a wider performance framework. The focus within the health system performance is on quality, equity, and efficiency. EuroREACH, 2012
Systems Thinking The 'Systems Thinking' frameworks attempt to create a framework that identifies important interrelationships and repeated events, and as such is a dynamic framework, instead of focusing on a static snapshot of health system structures. Atun & Menabde, 2008
WHO Building Blocks Framework for Action, has the aim of 'clarifying and strengthening WHO's role in health systems in a changing world'. The framework establishes a common understanding of what constitutes a health system, what its defining goals are, and what activities are included in health system strengthening. WHO, 2007
OECD HCQI Framework that defines 'quality of health care', placing it within a wider performance framework that acknowledges the key healthy policy goals adopted by the OECD and its member states. Arah et al, 2006
Commonwealth Fund The framework defines a health care system as: "the ways in which health care services are financed, organized and delivered to meet societal goals for health." A high performance health care system has four main goals: high quality, safe care, access to care for all people, efficient, high value care. Commonwealth Fund, 2006
Control Knobs A framework based on practical experience of designing, implementing and evaluating reforms. This framework conceptualizes the health system as "a set of relationships where the structural components (means) and their interactions are associated and connected to the goals the system desires to achieve (ends)." Hsaio, 2003
OECD 2001 OECD framework evaluates how good a health system is, or its performance, as the extent to which the system is meeting its objectives. While the OECD does not calculate performance of national health systems, it illustrates which of the key health indicators could be used for this purpose in each of the dimensions proposed. Hurst & Jee-Hugues, 2001
WHO 2000 Attempts to provide a clear conceptualisation of health system performance in terms of health system functions and goals. WHR, 2000
Behavioural Healthcare Framework to assess the effectiveness, efficiency and equity of health-care recognizing the influence of social and individual determinantes of health. Aday, 1998