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Toward a Consensus on Guiding Principles for Health Systems Strengthening

  • Robert C. Swanson mail,

    Affiliation: Department of Health Sciences, Brigham Young University, Provo, Utah, United States of America

  • Annette Bongiovanni,

    Affiliation: The QED Group LLC, Washington, D.C., United States of America

  • Elizabeth Bradley,

    Affiliation: Yale School of Public Health, New Haven, Connecticut, United States of America

  • Varnee Murugan,

    Affiliation: Yale School of Public Health, New Haven, Connecticut, United States of America

  • Jesper Sundewall,

    Affiliation: Division of Global Health, Karolinska Institute, Stockholm, Sweden

  • Arvind Betigeri,

    Affiliation: Health Systems Action Network, New Delhi, India

  • Frank Nyonator,

    Affiliation: Ministry of Health, Accra, Ghana

  • Adriano Cattaneo,

    Affiliation: Institute for Maternal and Child Health, Trieste, Italy

  • Brandi Harless,

    Affiliation: EntrePaducah, Paducah, Kentucky, United States of America

  • Andrey Ostrovsky,

    Affiliation: Health Systems Action Network, Baltimore, Maryland, United States of America

  • Ronald Labonté

    Affiliation: Institute of Population and Department of Epidemiology and Community Medicine, University of Ottawa, Ontario, Canada

  • Published: December 21, 2010
  • DOI: 10.1371/journal.pmed.1000385

Reader Comments (3)

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Valuable contribution - more debate needed

Posted by AnthonyZwi on 22 Dec 2010 at 01:29 GMT

This is a very timely and helpful article - I hope it will stimulate further debate and engagement. The ten guiding principles are informative and helpful, but deserve further refinement and elaboration, as intended by the authors. An example is the issue of 'context' - absolutely paramount but needs to be broader than described to include such issues as history, stage of development. development of the health system, resource availability, political (in)stability and conflict, and many more. The issue of politics and power - who has it, how it is used, and for what objectives - probably deserves a separate category as it requires analysis and understanding in its own right.

Clearly there are overlaps between the issues mentioned above and items already in the guidelines - I look forward to seeing how this develops further and to introducing the paper to our students.

Congratulations on getting this ball rolling!

Anthony Zwi

No competing interests declared.