Global Health Watch 1 in one file

HALE 2000
Government health care expenditure as a percentage of total expenditure
Figure B1.5 Association between healthy life expectancy and government
health care expenditure as a percentage of GDP, 2000 (Source: Mackintosh
and Koivusalo forthcoming 2005)
4 Agenda for health systems development
This section sets out an agenda to repair the damage to the public sector,
uphold the role of accountable government in health care provision and reassert
the principles of the PHC Approach. Its ten recommendations are not
stand-alone options but need to be implemented together, and tailored to the
particular social, political and economic realities of a given country.
Valuing and revitalising the public sector health worker – the lifeblood of
health services Changing and improving how health personnel behave and
function is so central to the rebuilding of health services, especially in developing
countries, that it cannot be treated as just another administrative or
bureaucratic task.
The performance of public sector health workers is affected by many factors
and calls for a concerted, coordinated programme of health worker support
and development. The re-establishment of a living wage is one requirement if
health workers are to behave ethically and function effectively – countries must
make up lost ground in the deterioration of public service salaries. Ensuring the
right number and mix of types of health personnel (for example, increasing the
number of nurses, medical auxiliaries and community health workers relative
to doctors) can help countries to create payrolls that are sustainable, efficient
and inclusive of incentives for trained staff to work in under-served areas.
Approaches to health care
83