1. FUNCTIONS OF THE HEALTH SYSTEM

2. Harmonization of Service Delivery 7.1 Yes 7.1 Yes  HA will provide strategic direction but the regional action /work plan may differ from region to region depending on epi. and demo. profile geared to meeting national targets.  Some MOH policies are lagging behind regional initiatives and there should be harmonization.

3. Harmonization of Service Delivery  Use of best practices in the region to inform national policies. 7.2 yes –There is some duplicity but the majority is complimentary services 7.2 yes –There is some duplicity but the majority is complimentary services  Duplication does not necessarily means fragmentation 7.3 Basic health standards should be updated, reviewed and new standards designed for introduction of new services. These should be implemented at all levels of care. 7.3 Basic health standards should be updated, reviewed and new standards designed for introduction of new services. These should be implemented at all levels of care.

4. Harmonization of Service Delivery 7.4 The term integration should be rephrased to Comprehensive care. 7.4 The term integration should be rephrased to Comprehensive care.  This can only be assured through an effective M&E programme with specific indicators

5. Gaps: Gender, Ethnicity & Age The gender disparity exists in both sexes and needs to be recognized. The gender disparity exists in both sexes and needs to be recognized. There should be a gap analysis so the programmes can be designed for specific groups and to aid in policy adjustment. There should be a gap analysis so the programmes can be designed for specific groups and to aid in policy adjustment.

6. Quality Assurance Even though basic health care standards are stipulated it is not enough to guarantee implementation of standards and quality of services. Even though basic health care standards are stipulated it is not enough to guarantee implementation of standards and quality of services.  There are no indicators to tell whether they are being used at the appropriate levels Countries are at various levels in terms of accreditation, licensing and certification Countries are at various levels in terms of accreditation, licensing and certification

7. Quality Assurance There is a need to review the legislations to have the ability to evaluate private institutions. There is a need to review the legislations to have the ability to evaluate private institutions. Most countries have identified external accreditation bodies but they are expensive and hence the region is looking at a regional accreditation body especially in the light of CSME. Most countries have identified external accreditation bodies but they are expensive and hence the region is looking at a regional accreditation body especially in the light of CSME. Instruments to measure performance: There are fragmented initiatives in several countries to address this but no comprehensive standardized instrument Instruments to measure performance: There are fragmented initiatives in several countries to address this but no comprehensive standardized instrument

8. Quality Assurance The question is relevant but most countries don’t have an effective complaint mechanism. The question is relevant but most countries don’t have an effective complaint mechanism. Standards for measuring health services performance in terms of Human, financial and technological resources relevant. Standards for measuring health services performance in terms of Human, financial and technological resources relevant. Methodology should include: Methodology should include:  Community participation – Encourage advocacy and consumer groups & health as a human right  Questions about existence of patient charts