Health Reform Manual: Eight Practical Steps
About the Health Reform Manual: Eight Practical Steps
Building on the foundational work of Getting Health Reform Right: A Guide to Improving Performance and Equity(GHRR, 2004), this manual offers a practical, step-by-step blueprint designed to empower government policymakers, analysts, advisors, advocates, and other key stakeholders worldwide. It simplifies the intricate processes of large-scale health reform management, making it accessible and adaptable not only for sweeping reforms but also for more targeted adjustments within smaller systems.
Outlined in this manual are the Eight Practical Steps to initiate and sustain effective health reform:
- Decide to Start: Committing to embark on the health reform journey.
- Create a Team: Assembling a dedicated team to drive the reform.
- Assess Performance: Evaluating current system performance and identifying key deficiencies.
- Diagnose Problems: Understanding the underlying causes of performance issues.
- Design Reform: Selecting a tailored package of reform initiatives.
- Strategize Politically: Conducting a political analysis to shape effective strategies.
- Manage Implementation: Overseeing the reform process to ensure practical results.
- Evaluate and Adapt: Assessing impacts and enhancing the system’s resilience and responsiveness.
Each chapter of the manual concisely details these steps, highlighting essential actions and providing extensive resources, including references for further reading. To enhance usability, the manual is equipped with 14 practical worksheets, four appendices, and a comprehensive glossary of terms, facilitating the adaptation of the Eight Steps to meet the diverse and dynamic challenges of health reform. This manual is crafted to be flexible, allowing users to navigate the steps in varying sequences to best address their specific contexts and reform objectives.
Contributions
The creation of the Health Reform Manual: Eight Practical Steps was made possible through the generous support of the Bill and Melinda Gates Foundation, in association with the India Health Systems Reform Project at the Harvard T.H. Chan School of Public Health. We are also proud to collaborate with the Alliance for Health Policy and Systems Research at the World Health Organization, which facilitated the publication and dissemination of this manual.
The framework of the Eight Steps manual draws upon the foundational text Getting Health Reform Right: A Guide to Improving Performance and Equity (Oxford University Press, 2004), authored by Marc J. Roberts, William Hsiao, Peter Berman, and Michael R. Reich. Their pioneering work continues to inspire and guide our efforts in health reform.
We are indebted to the invaluable insights and meticulous feedback provided by numerous reviewers of earlier drafts, which have significantly enriched this manual. Notable contributors include Koku Awoonor-Williams, Keith Cloete, Zarni Lynn Kyaw, and Walaiporn Patcharanarumol, who reviewed the draft for the Alliance’s publication. Additional insights were provided by Veronika Wirtz, William Hsiao, Adolfo Rubinstein, Susan Sparkes, Sian Tsuei, Heather Lanthorn, and Peter Berman. We are also grateful to the participants of the Fall 2023 graduate course “Doing Health Reform Better” at Harvard Chan School, especially Evangeline Liao, Sarah Payne, Hanne Vonen, Celline Wijaya, and Hao Yi, for their constructive suggestions.
Special thanks are due to Rodrigo Bianco for his creative input in designing Figure 3-1.
The division of labor in writing this manual was as follows: Michael R. Reich was responsible for the Introduction, Steps One, Five, and Eight; Anuska Kalita crafted Steps Three and Four; Paola Abril Campos developed Steps Six and Seven; and Anya Levy Guyer penned Step Two. Winnie Yip performed an overarching review and contributed significant revisions, particularly to Steps Three and Four. Final edits and integration of feedback were diligently carried out by Reich and Guyer, ensuring a coherent and comprehensive guide.
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Michael R. Reich
Paola Abril Campos
Anuska Kalita
Anya Levy Guyer
