The pursuit of ambitious goals of quality, equity, relevance and cost-effectiveness in the delivery of health services requires a high degree of coordination between different actors on the board of health. However, the fragmentation of the health system, illustrated by the boundaries between medicine and related public health, preventive and curative care, private sector and public sector, is generally observed disability. The reconciliation effort is a universal challenge. Partners such as policy makers, health managers, professionals, academic institutions and community must find areas of agreement and synergy to improve the performance of the health system.The pursuit of ambitious goals of quality, equity, relevance and cost-effectiveness in the delivery of health services requires a high degree of coordination between different actors on the board of health. However, the fragmentation of the health system, illustrated by the boundaries between medicine and related public health, preventive and curative care, private sector and public sector, is generally observed disability. The reconciliation effort is a universal challenge. Partners such as policy makers, health managers, health professionals, academic institutions and community must find areas of agreement and synergy to improve the performance of the health system.Why improving quality and equity in health services will remain a concern in most health systems, even in rich countries?
[...] Lessons learned in the field in projects led by teams of above five partners should help us better understand how to "make the mayonnaise" between activities and actors as different although complementary. To ensure better performance of our health systems, not only should we understand the strategies to develop each of the partners towards greater social relevance and performance, but also strategies to create lasting synergies. Bibliography I. Universities and the health of the disadvantaged: Building coalitions with the health professions, local governments, and their communities. [...]
[...] World Directory of Medical Schools, 7th ed World Health Organization, Geneva. V. Boelen Heck J. Defining and measuring the social accountability of medical schools. WHO/HRH/ World Health Organization, Geneva VI. Improving the social responsiveness of medical schools: Proceedings of the 1998 Educational Commission for Foreign Medical Graduates / World Health Organization [...]
[...] Towards Unity for Health A fragmentation must meet a tendency to unity of action between different partners. The Polygon Partnership " identifies five key partners whose action should be coordinated or integrated to respond optimally to the needs and expectations, and values already mentioned quality, equity , relevance and cost-effectiveness, namely policy makers, health managers, health professions, academic institutions and the community. Admittedly, each of these partners has its own traditions, references, objectives and organization. However, recognizing that unity of action between them is essential to meet the ambitious goals of health; compromises are necessary, desirable alliances and institutional changes for new roles and rules of operation. [...]
[...] For example, these include three main components: training of health personnel, professional practice and organization of health services, and examine how each of them is able to position itself in relation to health goals, establish working relationships with other partners and thus to demonstrate strategic vision. Concerning the training of health personnel, taking as example the establishment of the Faculty of Medicine, one of whose objectives is to train physician answering "ideally" the needs of individuals and populations that it intends to serve. [...]
[...] In the register "is true, there are efforts to reform the health system or to move towards universal coverage, is to introduce mechanisms to improve quality, or to install a control of its expenditure or to rule on ethical issues of particular concern. To meet the complexity and diversity of issues related to institutional changes necessary for the establishment of a health system designed to continually improve quality, equity, relevance and cost- effectiveness of services health, many sector initiatives have been taken. [...]
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