(I originally published this article in Linkedin)
The World Health Organisation in one of its definitions of 'Healthcare Systems' describes it as thus "A health system consists of all organisations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities. A health system is, therefore, more than the pyramid of publicly owned facilities that deliver personal health services. It includes, for example, a mother caring for a sick child at home; private providers; behaviour change programmes; vector-control campaigns; health insurance organisations; occupational health and safety legislation. It includes inter-sectoral action by health staff, for example, encouraging the ministry of education to promote female education, a well-known determinant of better health."
Here most of us who are conversant with 'Systems Thinking' understand a system comprises components but what most of us do not realise components by themselves does not maketh a system. The inter-connectivity and common standards coupled with the components is what completes a system. Bearing this in mind; it is hard to describe many countries health service structures as systems. Most health care is delivered in countries through 'cottage industry' frameworks where each healthcare organisation operates according to its standards with little connectivity to other healthcare services. Very few, if any, countries have all their health service delivery units (public and private) connected and provide standardised care (taking into account the different levels of provision of healthcare). Hence the use of the term 'Healthcare System' is a misnomer. Though for lack of a better terminology and as an aspirational term, we will continue to use this phrase.