Health system performance assessment: new framework for policy analysis

卫生系统绩效评估：政策分析的新框架

Experts from the World Health Organization (WHO) and the European Observatory on Health Systems and Policies have produced a long-awaited framework to conceptualize the assessment of health system performance.

世卫组织和欧洲卫生系统和政策观察站的专家制定了一个期待已久的框架，以概念化卫生系统绩效评估。

Health system performance assessment: a framework for policy analysis, published with support from the UHC2030 Health System Assessment technical working group (TWG) and the Universal Health Coverage Partnership, will help policy-makers to analyze possible origins and impact of poor performance on a particular health system outcome. In countries, especially those that receive external assistance, different and overlapping health systems assessments are often supported by different partners. The entry point for the UHC2030 TWG to develop this framework was the need for harmonizing and aligning the analysis of health system assessment (HSA) information across countries and HSA tools.

卫生系统绩效评估: 在UHC2030卫生系统评估技术工作组 (TWG) 和全民健康覆盖伙伴关系的支持下发布的政策分析框架，将帮助决策者分析不良绩效对特定卫生系统结果的可能根源和影响。在国家，特别是那些接受外部援助的国家，不同和重叠的卫生系统评估往往得到不同伙伴的支持。UHC2030 TWG制定这一框架的切入点是需要协调和调整各国卫生系统评估 (HSA) 信息分析和HSA工具。

The book places the newly introduced framework within the current evidence base while ensuring it is fit for the policy challenges of the 21st century. It offers policy-makers a strong performance orientation to analyze health system data and information.

这本书将新引入的框架置于当前的证据基础中，同时确保它适合21世纪的政策挑战。它为决策者提供了强有力的绩效导向，以分析卫生系统数据和信息。

Dheepa Rajan, Health Systems Adviser at WHO and one of the book editors, explains: “The core added value of this framework is the in-depth work we did to define the linkages between health system inputs, or functions, on the one hand, and health system outcomes, or goals, on the other. For each of the functions we also identify which topical areas need to be assessed to really understand that function’s contribution to overall system performance – information which is extremely policy-relevant.”

世卫组织卫生系统顾问兼图书编辑之一Dheepa Rajan解释说: “这个框架的核心附加值是我们为定义卫生系统输入或功能之间的联系所做的深入工作，一方面，卫生系统的结果或目标，另一方面。对于每个功能，我们还确定需要评估哪些主题领域，以真正了解该功能对整个系统性能的贡献-信息与政策极为相关。”

Strengthening health systems towards universal health coverage

加强卫生系统，实现全民健康覆盖

The innovation behind the new framework thus consists of diving deep into each of the four functions of the health system (governance, financing, resource generation and service delivery) and linking it with five specific performance goals: health improvement, people centredness, financial protection, efficiency, and equity of the health system.

因此，新框架背后的创新包括深入研究卫生系统的四个功能 (治理，融资，资源生成和服务提供)，并将其与五个特定的绩效目标联系起来: 健康改善，以人为本，财务保护，卫生系统的效率和公平性。

“The best way to use this framework is not to identify one single fix that can be tweaked in a sub-function to improve one of the health system goals,” explains Taavi Lai, former official in the Ministry of Health & Social Affairs, Estonia. “Rather, it can be used to more generally assess the performance of the different components of the system.”

爱沙尼亚卫生与社会事务部前官员Taavi Lai解释说: “使用此框架的最佳方法不是确定一个可以在子功能中进行调整以改善卫生系统目标之一的单一解决方案。”“相反，它可以用来更普遍地评估系统不同组件的性能。”

The framework encapsulates the areas where countries need health system strengthening interventions in order to move closer to universal health coverage. It is meant to organize the thinking around health system strengths and weaknesses in a way which offers insights into how health systems perform overall.

该框架囊括了各国需要加强卫生系统干预措施以更接近全民健康覆盖的领域。旨在组织围绕卫生系统优势和劣势的思考，以提供对卫生系统整体绩效的见解。

The HSPA Framework for UHC is thus a conceptual aid to analyze information emanating from health system assessments rather than an operational tool per se. It also allows for a common way of presenting health system assessment results, which can make comparisons between different assessment approaches and a shared focus on system performance easier.

因此，UHC的HSPA框架是分析卫生系统评估产生的信息的概念辅助工具，而不是操作工具本身。它还提供了一种呈现卫生系统评估结果的通用方法，可以使不同评估方法之间的比较和对系统性能的共同关注变得更加容易。