Adapted from: Unger J.-P., Criel B. Principles of health infrastructure planning in less developed countries. Int J Health Plan Manag 1995; 10: 113–128.

The following planning principles are designed for decision makers at central level but also for those responsible for local health systems and health districts. These principles organize the functions and relationships of health systems components (first-line health services, hospitals, and programmes). This relatively old paper has been inserted in this book because we feel the principles it offers are still relevant for strengthening health systems. The principles were formulated to make the most efficient and effective use of health care facilities and resources. They contribute to updating the concept of PHC, which re-emerged in the international policy agenda in 2006 (when the Director of the Pan American Health Organization [PAHO] took the initiative to revive this strategy) (Macinko et al., 2007).

Introduction

The highly varied efficiency in health systems and the international financial crisis may oblige MoHs to rationalize their structures of health care provision and to focus on the allocation of scarce resources to the most efficient types of facilities in their respective health systems. The aim of this chapter is to assess some of the principles for the identification of these entities, the definition of their functions and their relationships to the other elements (such as disease-specific organizations, social services and academic institutions) in the health system.