Health reform

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(This article is about movements to improve health. For more information about political movements affecting the delivery of health care and health care systems, see Health care reform.)

Health Reform was a movement in the 18th century where hospitals were continuing to be upgraded and improved. The term "health reform," today also referred to as "health system strengthening," is a rising global issue. Behind the term, on an international or global level, is the notion that root causes of health problems are perhaps better addressed not be countless "vertical" program interventions, but by strengthening a country's ability to manage its own health programs. For a long time, many bilateral donor organizations (USAID, GTZ, DFID, others) and a string of private and non-governmental organizations or NGOs (such as CARE, Catholic Relief Services, and others) have provided intervention programs -- to prevent AIDS, malaria, childhood illnesses (e.g., diarrhea, measels). For decades, organizations advocated for assistance to counter specific diseases or to help specific regions. Many of these programs were very successful -- however, by land large, their impact faded when donors withdrew resources. More vertical programs were launched, but now with the intent of ensuring they were "sustainable" -- a term that suggests that each country must take charge of its health programs. Today, it is at last clear that, in order to achieve truly sustainable health programs, a country must have a range of broad skills to manage its health system -- this includes financial and human resources as well as logistics, information, and medical and public health expertise.

Hampering these efforts is the need by donor organizations to account for the "impact" they are having. It is relatively easy to show that an oral rehydration therapy (ORT) program has significantly reduced child deaths in an area where diarrhea is a big killer, but not at all easy to demonstrate the impact of monies spent on training, information systems, national health accounts (NHA) or other "capacity development" exercises.