Health care systems in low- and middle-income countries

Abstract

This review draws on what is now quite an extensive literature on the deficiencies of health care systems and on the Health Systems Evidence database. However, the poor quality and uneven coverage of evidence on the strengthening of health care systems means that evidence of deficiencies is stronger than evidence of remedies. Moreover, the specific circumstances of individual countries strongly influence both decisions about which approaches might be relevant and their success, so any generalizations made from health systems research in particular coun- tries must be carefully considered. It is unlikely that there is one single blueprint for an ideal health care system design or a magic bullet that will automatically remedy deficiencies. The strengthening of health care systems in low-and middle-income countries must be seen as a long-term developmental process.