Table 1

Chronology of major health system definitions, frameworks and concepts


Main governance aspects


Health System Performance

First emphasis on stewardship as a health system function


Essential Public Health Functions

Strengthening public health regulation and enforcement capacity as one of the eleven essential public health function


Control Knobs

Regulation as one of the health system control knobs to improve performance


Strengthening Health Systems

Strengthening health system capacity by focusing on stewardship and regulation


Health System Building blocks

Articulation of governance as one of the six major building blocks of the health system, and rephrasing stewardship into governance


Health Systems Dynamics

Identifying stewardship and organizational arrangements as one of the four levers available to policy makers to achieve objectives and goals


Maximizing positive synergies

Ensuring that governance along with the other six functions of a health system are driven by people to promote equity


Systems thinking for Health Systems Strengthening

Links system thinking to health system building blocks, and conceptualizes governance across the building blocks.


Monitoring Building Blocks of the Health System

Proposes indicators for monitoring governance and the other building blocks of the health system


Mikkelsen-Lopez et al. BMC International Health and Human Rights 2011 11:13   doi:10.1186/1472-698X-11-13

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