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Table 4 Key dimensions of a health system [43]

From: An implementation research programme to support an intravenous iron intervention for pregnant women with moderate and severe anaemia in Malawi: study protocol

Dimensions Description
Organisational structure provides an overview of how the health system in the country is organised and outlines the main actors and their decision-making powers; discusses the historical background for the system; and describes the level of patient empowerment in the areas of information, rights, choice, complaints procedures, safety, and involvement.
Financing provides information on the level of expenditure, on who is covered, which benefits are covered, the sources of health care finance, how resources are pooled and allocated, the main areas of expenditure, and how providers are paid.
Regulation and planning addresses the process of policy development, establishing goals and priorities; deals with questions about relationships between institutional actors, with specific emphasis on their role in regulation and what aspects are subject to regulation; and describes the process of health technology assessment (HTA) and research and development.
Physical and human resources deals with the planning and distribution of infrastructure and capital stock; the context in which IT systems operate; and human resource input into the health system, including information on registration, training, trends, and career paths.
Provision of services concentrates on patient flows, organisation and delivery of services, addressing public health, primary and secondary health care, emergency and daycare, rehabilitation, pharmaceutical care, long-term care, services for informal caregivers, palliative care, mental health care, dental care, complementary and alternative medicine, and health care for specific populations.
Principal health care reforms review reforms, policies, and organisational changes, which have substantially impacted health care.