Integrating Health System
Integration of the health system entails combining health services into a more advanced level that is manageable and cost-effective to enhance quality care services to everyone. Mainly, it involves financial plans, health approaches, and operational activities that can be implemented for sustainability purposes and favors all (Topp et al., 2018).
Many scholars have described the integration of the health system in different ways. Still, all their concepts aim in the framework of coordinating, organizing, and managing several healthcare activities and resources to enhance efficient and effective service delivery (Topp et al., 2018). However, this process can be challenging in low and middle-income countries due to pre-conditions such as fewer health centers with few staff members, insufficient medical health equipment, and accessibility. Thus requires more advanced approaches in facilitating the integration process. This study discusses the assessment of the health system in the low-income country through a causal diagram of system thinking.
Causal Loop Diagram
In low-income countries such as Afghanistan, the health system has become a major issue due to inefficiencies of health information and funds to advance healthcare (Paul et al., 2018). A study review conducted in Afghanistan shows various reforms made with improving the health system. The health system used is Pay for Performance (P4P) to strengthen health system performance and identify the agency problems blocking the systems from coordinating (Alonge et al., 2017).
A causal loop diagram is a presentation of system thinking that improves the cognitive thinking of individuals through creativity and logical reasoning. It follows four basic frameworks in its development; the variables, links between them, the signs on the links, and the loop sign. Based on the health system issue of Afghanistan, the causal loop diagram helps determine causal relationships between variables identified (Alonge et al., 2017). The arrows connect through the links and variables to help understand the connection, forming a structural statement that can be applied in developing an effective health system to solve the health problem in this country.
For instance, the diagram above represents a causal diagram of public health services provided in bridging the identified gaps to enhance strong health system in the country. The arrows are moving in the same direction thus proving positive relationship in the three variables, hence an indication, that the pay for performance system has helped in bridging the gap and restoring quality healthcare in the country, ever since it was introduced (Alonge et al., 2017).
Major Components of the Pay for Performance System
Pay for performance system is an approach used especially in low and middle-income countries to strengthen their health systems. Mainly it involves donor organizations that decide to invest in program activities and projects that can benefit these low-income countries and improve the health system (Alonge et al., 2017). The major components are; quality maternal and child health, accessibility of essential drugs and availability of trained health staffs. For instance, pay for performance enables the donor to provide monetary incentives to the beneficiary of the implemented programs based on the agreement.
The monetary incentives are then used to fund other similar programs that can help improve the health system in Afghanistan. Therefore, the health system discussed above also helps recognize agency problems that might arise. For instance, problems such as an agent using the projects’ funds for personal gains are discouraged and can easily be identified using the pay for performance approach.
Core Services Provided
The pay for performance system enhances quality service delivery, health workforce, and leadership (Manyazewal, 2017). Through the sponsorship of programs by the donors, the beneficiaries, such as women in the community, can access free maternal and child immunization services. The health system also equips the programs’ participants with enough knowledge and skills through training, thus managing their wellbeing. These systems are managed mainly by non-governmental organizations.
Payments and Funding of the Services
This health system is mostly provided to low-income count
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