A Guide to Health Reform: Eight Practical Steps instructs readers, in clear language and general terms, about how to navigate the complex process of health system reform. It is written for health reformers (including government policy makers, analysts, advisors, advocates and other stakeholders) in any country to use as they plan and implement health reform.
The Guide breaks down the health system reform process into eight steps. Each step is presented in a short chapter that highlights between four and six key actions and provides additional resources. The eight steps can be read (and applied) in a different order depending on the needs and circumstances of health reformers. The Guide also includes worksheets, appendices, and a glossary.
- Introduction presents the overall purpose of the Guide. In it, the authors describe how the Guide relates directly with the book, Getting Health Reform Right: A Guide to Performance and Equity, and provides basic definitions of key terms. The Introduction also notes who the Guide’s intended audiences are and how they can use and adapt its eight-step approach to health reform.
- Step One: Deciding to Start a Health Reform Process outlines a process and key considerations to contemplate when initiating a health system reform initiative.
- Step Two: Creating a Health Reform Team discusses how and why to form a Health Reform Team, the multidisciplinary group of people who will focus on the mission of pushing a health system reform forward.
- Step Three: Assessing Health System Performance and Defining Performance Problems details a systematic approach to determining how well a health system is currently functioning in order to identify its important performance problems.
- Step Four: Diagnosing the Causes of Performance Problems focuses on identifying the causes of the performance problems (identified in Step Three) and connecting them to policy control knobs that can be changed through health system reform.
- Step Five: Deciding on Your Reform Package discusses how to approach making decisions about the package of policy reforms that will be included in a health system reform initiative.
- Step Six: Conducting Political Analysis and Designing Political Strategies addresses how health reformers can analyze the politics of a proposed health system reform initiative and identify political strategies to improve the likelihood of its success.
- Step Seven: Managing the Implementation of Health Reform to Achieve Results outlines a process and key considerations for implementing an approved health system reform initiative.
- Step Eight: Evaluating Impacts and Creating Sustainability for Your Health Reform discusses how to approach monitoring and evaluating the impact of a health system reform initiative, particularly to foster its long-term viability.
- All Worksheets (.pdf)
- All Worksheets (.docx)
- Worksheet Intro-1: Complete checklist of key actions for each Step of health reform
- Worksheet 1-1: Guiding questions for defining ethical principles for health reform
- Worksheet 1-2: Guiding questions for an informal risk assessment
- Worksheet 2-1: Sketch your reform process to identify skills and expertise needed on the Health Reform Team
- Worksheet 4-1: Information required to understand the policy control knobs in the current healthcare system
- Worksheet 6-1: Getting ready to do your applied political analysis
- Worksheet 6-2. Identifying your stakeholders
- Worksheet 6-3. Analyzing the positions, power and interests of your stakeholders
- Worksheet 6-4. Develop and track your political strategy implementation
- Worksheet 7-1: Guiding questions for a Delivery Capacity Review
- Worksheet 7-2: Stakeholder analysis for health reform implementation
- Worksheet 7-3: Implementation plan questions
- Worksheet 7-4: Template for progress-tracking table
- Worksheet 7-5: Guiding questions for developing communications strategies
Reich MR, Campos PA, Kalita A, Guyer AL, Yip W. A Guide to Health Reform: Eight Practical Steps. Boston, MA: Harvard T.H. Chan School of Public Health, India Health Systems Reform Project. August 2023.