Health systems strengthening refers to initiatives and strategies that improve one or more of the functions of the health system and that leads to better health through improvements in access, coverage, quality, or efficiency, ensuring it can address health threats. A well-functioning health system is built on having trained and motivated health workers, a well-maintained infrastructure, and a reliable supply of medicines and technologies, appropriate service delivery approaches, backed by adequate funding, all these articulated in strong health plans and evidence-based policies.
Strengthening of health systems involves the development and implementation of primary health care oriented health policies and realistic strategic plans that focuses on improving the institutional and organizational capacity of a country to provide health services to the whole population. These policies and strategies are prepared within the context of national socio - economic development, and the improvement of health services performance in terms of quality safety, effectiveness, efficiency, coverage and equitable access and use. This contributes to the attainment of the goal of Health for All, where the healthcare system is responsive to the needs of all members of society, regardless of their socioeconomic status, ethnicity, culture, gender or other factors.
Health systems governance refers to the processes, structures , institutions, legal frameworks and partnerships that are in place to oversee and manage a country's healthcare system. The public sector/government is entrusted with oversight responsibilities that includes managing the relationships between different actors and stakeholders (state and non-state) involved in healthcare. These include government agencies, public institutions involved in health care and training, funding/donor agencies/initiatives, private sector institutions/initiatives, patients and their families, people and communities and civil society organizations. Effective health systems governance enables a county’s healthcare system to optimally provide health care services that are are accessible, equitable, efficient, affordable, acceptable and of high quality for all.
Health systems governance ensures that strategic policy frameworks exist that guide healthcare delivery, and mechanisms for monitoring, evaluating and reviewing the health system’s performance. This is combined with effective oversight, coalition-building, provision of appropriate regulations, incentives, attention to system design, organizational structures and accountability. Health systems governance enables the different actors and stakleholders to work in a complementary mannerand ensure efficient use of resources and mutual accountability for results.