Conceptually mapping how investing in essential public health functions (EPHFs) and common goods for health (CGH) can improve health system performance

Michelle Amri ^1* Dheepa Rajan ² Kira Koch ³ Alexandra J Earle ³ Susan P Sparkes ³ Yu Zhang ³ Sohel Saikat ³ Jesse B Bump ^4,5

• ¹ University of British Columbia, Vancouver, Canada
• ² European Observatory on Health Systems and Policies, Brussels, Belgium
• ³ World Health Organization (Switzerland), Geneva, Geneva, Switzerland
• ⁴ Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, United States
• ⁵ Bergen Centre for Ethics and Priority Setting, Faculty of Medicine, University of Bergen, Bergen, Hordaland, Norway

Background: Calls for investing in essential public health functions (EPHFs) and common goods for health (CGH) are numerous, but it is often unclear to policymakers how such investments lead to health system improvements. Objectives: To showcase plausible pathways between actions taken to improve specific health system functions--in other words, investments in EPHFs and CGH--and their impact on health system performance, the health systems performance assessment framework for Universal Health Coverage is used. We draw on three examples--community engagement and social participation, taxes and subsidies, and public health surveillance and monitoring--to demonstrate how action in these areas can improve health systems. Conclusions: This conceptual mapping also points to the crucial role of good governance and demonstrates how investing in multiple EPHFs and CGH can trigger a chain reaction to spur broader health system improvement.