Table 1 Summary of Kruk et al.’s conceptual framework on high-quality health systems

Foundations

Population

Individuals, families and communities; system users; health literacy and cultural norms

Health literacy of vulnerable populations

Governance

Leadership structures including contracting, payment and institutions for accountability; institutions for measurement, evaluation and improvement; trustworthy data

Transparent audits to prevent corruption

Platforms

The accessibility and organization of care delivery, including geographic access and distribution of facilities

Public and private mix of healthcare financing and delivery

Workforce

Personnel-based resources within the health system, including healthcare workers and managers

Delegation of roles and task-shifting

Tools

Physical and technological resources including software, equipment, medical supplies and use of data

Integration of electronic medical records

Processes of care

Competent care and systems

Evidence-based healthcare that provides correct and appropriate diagnosis and treatment

Accurate screening and diagnosis of non-communicable diseases

Positive user experience

People-centered care that involves patient values, including respect, choice of provider, wait times and ease of use

Patient satisfaction with wait times

Quality impacts

Better health

Effects on patient symptoms, health status, function, quality of life, morbidity and mortality

Maternal and child mortality rates

Confidence in system

Patient-reported satisfaction and trust in health systems

Voluntary re-enrollment in insurance schemes

Economic benefit

Ability to participate in the economy, financial protection, and reduction of financial and resource waste

Reduction in unnecessary healthcare