The authors argue that part of the explanation of the failure to reduce maternal mortality
and morbidity globally is the way that the health system is conceptualized and addressed in
much of the maternal health field. They argue that there is a need to move from an implicit
mechanistic approach to health systems towards a conceptualization of health systems that
recognizes the fundamentally social and dynamic nature of health systems and health policy
interventions “where everything depends on how people interpret and implement policy, and
how users respond to new programmes and services” (McPake, Blaauw et al. 2006).
They use data from a range of studies carried out looking at maternal health services from a health
system perspective in two middle income countries (South Africa, Russia) and two low income
countries (Bangladesh, Uganda) to illustrate argument.
Health Systems Development Programme working paper 15/06, 17 pp.