Publications
HST provides free electronic access to over 500 health systems research related reports, publications and papers. Close to 300 of these are publications that have been commissioned and funded by the Trust. Topics include among others district systems development, drug supply management, human resource development, informatics, legislation, finance, environmental health, mental health, lessons learnt, nutrition and sexually transmitted diseases / HIV/AIDS. The main publication of the HST is the annual South African Health Review. From 2005 all HST publications will be available in low resolution only. To explore the range of publications HST offers use the Advanced search to search using a variety of criteria.

Executive Summary

Improved performance in controlling emerging and re-emerging diseases in developing countries is dependent on the quality, equity and efficiency of health systems. Rapid progress towards targets is greatly hampered by weak, poorly functioning or in some cases non-existent health systems. It is critical to know how best to approach health system strengthening, and what specific actions are appropriate in different settings. Much is known about the barriers or constraints to greatly increasing (scaling up) health services. However, remarkably little is known about how best to relax these constraints, whether through reformed service delivery strategies, or different human resource management policies, or new organizational structures.

The central concern of this book is how knowledge of health systems can be increased and applied to improve the health of the worst-off of the worlds population. Health systems research has much to contribute to our understanding of health systems and policies. Research can play a major role in policy formulation, especially when policy questions can be formulated in terms of clear and empirically verifiable hypotheses. The book provides case studies showing that the application of health systems research has contributed to problem resolution, and that a widely applicable scientific body of knowledge is developing. Progress is reviewed in the areas of equity, user fees, community health insurance, management reforms and the role of civil society organizations. Decision makers and community advocates can benefit from this knowledge for the design and implementation of sound policy.

Funding for health systems research in developing countries and by developing country researchers is meagre. Evidence suggests that such funding is at most 0.02% of health expenditure, far too low to have an impact on health system development. Funding should be mobilized from within national health systems as well as from science and technology budgets and international sources. Priority problems for research need to be identified in relation to health system and development goals and in consensus with policy makers. The book presents the results of a survey of priorities identified at country level, as an input to further thinking on national and global research agendas.