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Strategizing national health in the 21st century: a handbook

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Dheepa Rajan
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This handbook is designed as a resource for providing up-to-date and practical guidance on national health planning and strategizing for health. It establishes a set of best practices to support strategic plans for health and represents the wealth of experience accumulated by WHO on national health policies, strategies and plans (NHPSPs). WHO has been one of the leading organizations to support countries in the development of NHPSPs. The focus on improving plans has grown in recent years, in recognition of the benefits of anchoring a strong national health sector in a written vision based on participation, analysis, and evidence.
Dheepa Rajan
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The global health environment is becoming increasingly complex. Social, demographic and epidemiological transformations fed by globalization, urbanization and ageing populations pose challenges of a magnitude that was not anticipated three decades ago. In addition, recent global health security threats such as the Ebola virus disease or Zika virus outbreak, and the growing mismatch between the low performance of health systems and the rising expectations of societies, are increasingly becoming a cause for political concern. This often leads to countries prioritizing, or re-prioritizing, efforts towards strengthening health systems, moving towards universal health coverage (UHC) and implementing the idea of health in all policies. Countries recognize that these calls for efficiently strengthening health systems and improving health security must be translated into robust, realistic, comprehensive, coherent and well balanced health policies, strategies and plans. In the post-Millennium Development Goals (MDGs) era, they also recognize that in pluralist, mixed, public-private health systems, these policies, strategies and plans have to relate to the entire health sector and cannot be limited anymore to “command-and-control” plans for the public sector. Functional health systems that deliver high quality services to the population are the main priority for governments. Achieving this requires permanent, well-structured and dynamic processes, with a true consensus between the demand and supply of services, as well as between governments, services providers and the population. A solid, evidence-informed policy dialogue is the only real way to achieve this in the 21st century. Rationale for this handbook Furthermore, it is now widely understood that national health policies, strategies and plans (NHPSPsI) extend much beyond “health care”, i.e. clinical personal services, and cover the broad public health agenda, including disaster preparedness, risk management and the International Health Regulations, encompassing action on the social determinants of health and the interaction between the health sector and other sectors in society. In the face of both these gradual and acute changes over the past decade, NHPSPs, and more importantly the process of developing the NHPSP, need to be adapted and given a different focus. This handbook aims to make the case that strategizing – meaning designing plans and policies to achieve a particular goal related to the health of a nation – is absolutely critical in the 21st century. It is not only recommended by the Member States of the World Health Organization (WHO), but is also feasible for all countries in all settings. This handbook builds on the experiences gathered by WHO and its partners during the MDGs era. It presents the way of developing NHPSPs from a new pluralistic perspective, and it advocates for policy dialogue as a means to ensure inclusiveness and the participation of both service providers and the population in debates and the decision-making process with the government, as well as in the follow-up, monitoring and evaluation of NHPSP implementation.