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