It was developed in a collaborative process involving multiple stakeholders and UHC2030 partners at global and national levels during 2017. It outlines health system performance dimensions and policy entry points to promote UHC through HSS, including critical action for the way forward and principles to guide action.

Health Systems Policy Areas and Actions

Improved health system performance requires national, regional, and global action in three interrelated health systems policy areas of service delivery, health financing and governance. 

Health systems strengthening should focus on five dimensions of health system performance:

  1. Equity
  2. Quality
  3. Responsiveness
  4. Efficiency
  5. Resilience

Service delivery

  • Expanding frontline services, particularly primary health care 
  • Scaling up investment in skilled health workers 
  • Improving access to medicines and health technologies 
  • Innovating to meet the health needs of vulnerable and marginalised groups 
  • Expanding engagement with non-state providers 
  • Improving patient safety and quality of health services 
  • Implementing International Health Regulations and service delivery models that promote resilience 
  • Fostering multi-sectoral action to address the social determinants of health.

Health financing

  • Mobilising resources through progressive taxation and prioritising health, within a sustainable macroeconomic framework 
  • Expanding pooling arrangements to improve financial protection for all 
  • Strategic purchasing to increase efficiency of health spending, with a focus on public goods and public health.


  • Fostering citizens’ platforms and people’s voice mechanisms 
  • Promoting freedom of information and expanded use of quality data
  • Adopting legal frameworks supporting access to quality health services 
  • Developing policy dialogue platforms and multi-sectoral action 
  • Promoting regional and global mechanisms for collective action and partnership
  • Strengthening research and development, including technology transfer mechanisms.

No one-size-fit all approach

There is no one-size-fit all approach to health systems strengthening. The following principles have been identified to guide action in prioritising and implementing HSS:

  • Leaving no one behind: a commitment to equity, non-discrimination and a human rights based approach
  • Transparency and accountability for results
  • Evidence-based national health strategies and leadership
  • Making health systems everybody’s business with engagement of citizens, communities, civil society and private sector
  • International cooperation based on mutual learning across countries and development effectiveness principles.

Executive summary of the Joint Vision in other languages






(Arabic is to follow soon)

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