Strategizing national health in the 21st century: a handbook

26 January 2017

Strategizing national health in the 21st century: a handbook


The 21st century has brought new challenges to the health sector, marking the beginning of a new era in health system planning. The global health environment is becoming increasingly complex, with social, demographic and epidemiological transformations fed by globalization, urbanization and ageing populations. A growing mismatch between the low performance of some health systems and the rising expectations of societies are progressively becoming a cause for political concern, reflecting the need of reforms.


To help and guide countries confronting these situations, the Health Systems Governance and Financing Department at World Health Organization (WHO) headquarters recently published Strategizing national health in the 21st century: a handbook. This is a critical normative guide to support countries in their endeavours to orient the health sector and steer closer towards Universal Health Coverage (UHC). It acknowledges countries’ renewed attention towards prioritizing, or re-prioritizing, efforts for health systems strengthening, moving towards UHC and the implementation of the health in all policies idea. The handbook is grounded in the notion that robust, realistic, comprehensive, coherent and well balanced health policies, strategies and plans are the core and the basis for orienting the health sector as a whole.


Strategizing national health in the 21st century: a handbook aims to fill an existing gap in the knowledge base in this area, as the existing published material dated back to the mid-2000s and was very academic in nature. The handbook is written in simple and understandable language, makingit accessible to its main target audience – governments and in particular health and finance ministries -but also to all the stakeholders involved in national health planning, which may have different profiles from one country to another


The handbook is the result of intense collaborative work between WHO and external experts involved in different areas of health systems planning. They worked on the content and structure of the handbook for over two years through several revisions and consultation processes. An introductory chapter plus twelve chapters addressing the most critical issues on national health planning are the result of these collaborations. The chapters are organized around the health policy & planning cycle: population consultation, situation analysis, priority setting, formulating strategic plans, operational planning, costing, budgeting, and monitoring & evaluation. There is a clear common thread running through all chapters and each chapter is also a stand-alone read to be easily understood and used by stakeholders interested in specific topics. Finally, the four last chapters address crosscutting issues for health system planning: distressed health contexts, sub-national planning, legal frameworks, and intersectoral planning.


The EU-Luxembourg-WHO Universal Health Coverage Partnership (UHC-Partnership) has been a crucial enabler for the handbook creation process. The UHC-Partnership financed the project, recognizing the importance of a normative guide on health system planning topics. Moreover, the UHC-Partnership gave WHO experts insight, access, lessons learnt and best practices gathered during the course of the UHC-Partnership in all of the 28 member countries. The close interaction among WHO headquarters, regional offices, country offices, and Ministry of Health planning departments fed the handbook content. All along, the document complements the theory on strategic national planning with illustrative country examples to inspire and guide the reader through the decision making process.


Launched during the Fourth Global Symposium on Health Systems Research in Vancouver in November 2016, it is now available online.