Comment for "The Importance of Health Management in Developing Countries; Choosing a Health Champion or a Slaughterhouse Executioner"

Commentary

Improving population health is a challenge facing all countries, both developed and developing. As healthcare has become more complex and specialised, management faces serious governance gaps. The current service delivery system is not robust enough to apply knowledge and technology in a consistent, safe, effective, timely and efficient manner, as argued by authors Kalavani and Akhondzardainien in a recent article published in the Journal of Quality in Health Care & Economics [1].

As countries strive to close these gaps, we must seek solutions that are humane and respectful of people’s needs and preferences. Most importantly, we must build a health management system for the rest of the 21st century that is more equitable. Transformations are needed at all levels, including the relationship between the physician and the health care team with patients; the structure and functioning of health care organisations; the purchasing and financing of health care; the regulatory and accountability environment; among others [2].

The success of this process depends on an enabling policy environment to act on three main fronts:

• Designing a Comprehensive Strategy: Management improvement is seen as an on-going, long-term process to improve the quality of healthcare and optimise comprehensive organisational processes that include a consolidated vision, plan and policy framework aligned Commentary with a broad multi-sectoral strategy. Reform on this scale will require an overhaul of organisational structures, business models and institutions; fundamental changes in cultures, habits and attitudes; and considerable investment [3, 4].
• Strengthening Links with Policy Sectors and Citizen Power: Integration and collaboration between political science and organised citizenship would benefit the quality of health and welfare management as a whole, as such interaction is likely to result in better policies and decisions. It is from this perspective, in which all stakeholders should be equally involved in achieving better quality management, that the concepts of a sustainable and resilient health system should be deployed [5, 6, 7].
• Build Institutional and Operational Capacity: Health management that supports holistic and equitable investment in the coming years will require adaptive structures and integrated multi-sectoral decision- making processes to improve people’s quality of life; the support of institutional and community networks rather than single-person services; and organisation under principles of transparency, multidisciplinary responsiveness, shared accountability, efficiency and fair distribution of resources. But, above all, it must generate a virtuous circle with resilient leaders [8].