Published online by Cambridge University Press: 18 December 2009
The ultimate objective of health care services is to improve health status. In Chapter 3, we saw that choosing the right set of clinical interventions is critical to achieving better health within constrained resources. Chapters 4 and 5 discussed ensuring that all people can afford, and have access to, those interventions. In addition, ensuring that the appropriate medical infrastructure and institutions are in place is also key to achieving better health, as we will see in the next chapter.
However, none of these factors is enough to guarantee improvements in health status. Any intervention—whether clinical or enabling—will not improve the health of individuals if the individuals do not choose to take advantage of it, or if providers do not offer the intervention to their patients. For example, a government can decide to fight a measles epidemic by providing immunizations for children, by allocating public subsidies away from curative services and toward the primary preventive care services, and by geographically targeting communities most in need of measles immunization. None of these interventions, however, will improve measles immunizations for children if the parents do not choose to bring their children into the clinics that provide the service and if community health workers are not skilled.
Figure 6.1 expands the relationship presented in Figure 2.1 to show how health policy affects health status and is mediated by changing behaviors of the stakeholders.