Health system performance comparison: new directions in research and policy

The concept of the ‘health system’ has become central to debates about health policy since the publication of the World Health Report 2000[1]. In that report, the WHO defined the health system as “…all the activities whose primary purpose is to promote, restore or maintain health”. That broad definition is closely aligned to the role of most health ministries, which includes the promotion of health and prevention of disease, as well as the organization of health services. It is therefore not surprising that many policy makers have expressed particular interest in understanding better how their health system works, and identifying the scope for improvement.