Health systems financing: putting together the “back office”

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Abstract
As Africa attempts to achieve ambitious millennium development goals, many critical challenges confront healthcare systems. In advancing towards these goals, African countries need to review and reform their healthcare delivery systems, and they need to devise innovative approaches to deal with daunting problems.1 2 Development of healthcare systems and improvement in health outcomes, based on investment in programmes focusing on specific diseases, continues to fragment health systems, leaving the basic infrastructure weak and incapable of delivering equitable, broad based services. There has been much discussion about integrating the primary, secondary, and tertiary tiers of the health system (the “front page”) but inadequate attention has been paid to identifying and strengthening the actions that are required to deliver the basic package of care (the “back office”) at each level of care.