The 1990s have seen a fundamental questioning of the nature, form and content of health systems. Evidence has accumulated that in terms of efficiency and equity, no country can be satisfied with the performance of its health system. Concerns include: the extent to which health systems are responsive to health needs as opposed to professional preferences; the need to ration access to care and how best to do it; how to make services more responsive to users; and how to ensure that the needs of the poorest and most disadvantaged are met. Countries across the world, whether rich or poor, are attempting to change how health systems are financed, organized, and managed. Proposed reforms are often radical; progress in implementing reforms is often slow; consensus is notably absent. These papers by leading academics and practitioners shed light on reform ideologies, strategies, and experiences.
In: Mills A (ed), Reforming health sectors. London: Kegan Paul International, pp 350.