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Presentation of the operational approach to health system strengthening in the WHO Regional Office for Europe


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Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark Telephone: +45 39 17 17 17 Fax: +45 39 17 18 18 E-mail: governance@euro.who.int Web: http://www.euro.who.int/en/who-we-are/governance

Regional Committee for Europe

Sixty-second session

Malta, 10–13 September 2012 24 August 2012


Ministerial lunch (Tuesday, 11 September 2012)

Presentation of the operational approach to health system strengthening

in the WHO Regional Office for Europe



At the sixty-first session of the WHO Regional Committee for Europe in Baku in September 2011, the Regional Director presented a draft of the new operational approach to health system strengthening (HSS) in the WHO Regional Office for Europe in her plenary presentation to the Member States. This operational approach was further described in the information document EUR/RC61/Inf.Doc./9 entitled Health systems for better health: the WHO/Europe package of support for health systems strengthening.

This draft document has since evolved into a final document Towards people-centred health systems: An innovative approach for better health outcomes, which takes the vision and mission of HSS put forward in

Health 2020, the European health policy framework, a step further. It also presents the WHO Regional Office for Europe’s operational approach, products and services to revitalize HSS for greater health gains.


What is the new operational approach and what is it not?

It is an operational approach to HSS used throughout the Regional Office with the aim of tightening the links between health gains and HSS, building on many years of country work on HSS in the Region.

It is not a new health systems framework or strategy, but a different “lens” and way of applying the work done on HSS, so that the Division of Health Systems and Public Health can work more closely with the disease-related programmes/divisions to improve health outcomes. The approach also improves synergies between the six technical programmes within the Health Systems and Public Health Division to deliver coordinated work to countries.

“This document presents  the operational approach 

of the WHO Regional  Office for Europe to re‐

vitalize health system  strengthening for greater 

health gain.” 


Ministerial lunch (Tuesday, 11 September 2012) page 2

At the heart of our operational approach is the provision of support to Member States to examine and scale up delivery of people-centred core services in areas that are of high priority for health improvement, by removing health system barriers that stand in the way.

The approach rests on the three pillars shown in Fig. 1 below:

(i) specification of priority health improvement areas;

(ii) ensuring universal coverage of core services in the priority health improvement areas; and (iii) removing health system barriers that limit the coverage of core services.

While keeping a systemic orientation, this approach allows a tighter link to be forged between HSS actions and policies, on the one hand, and priority health outcomes, on the other. This linkage is articulated by putting core services for priority health improvement areas in the spotlight and examining coverage rates in general and for vulnerable groups in particular.


Fig. 1. Three pillars of health system strengthening 




Our way of working

Working this way, we hope to implement our vision of people-centred health systems that strive to attain maximum health gain for the population given fiscal constraints and to protect individuals from experiencing undue financial hardship due to seeking care, while remaining responsive to citizens’ legitimate expectations.

While we focus on health systems, we acknowledge the critical role of health determinants that lie outside the health sector and we seek ways to influence these determinants.

Cross‐divisional products and  services 


HSS for accelerating  outcomes for  noncommunicable  diseases 

HSS for halting the  epidemic of multidrug‐

resistant tuberculosis 



Ministerial lunch (Tuesday, 11 September 2012) page 3

3 | P a g e

This approach will be used by the Regional Office for carrying out country-specific and regional analytical work related to health systems, organizing training events, engaging in policy dialogues and developing tighter collaboration with technical programmes within the Regional Office.


1. In the opinion of Member States, what are some critical health system challenges that have hindered the achievement of desired health outcomes in countries?

2. In which areas would you like to see the WHO Regional Office play a more prominent role

in overcoming health system barriers?


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