What are “Health Systems Stewards”?

Each community/country has a burden of ill-health, and an anticipated burden. There are interventions that are more or less efficient at addressing that burden, and there is a health system structure that delivers those interventions, and responds to future health problems. Citizens may be more or less involved in social mobilization, political advocacy, financial support, and other ways to transform that health system.

In an ideal world, the health system structure and focus of each community would mirror the burden of ill health, and build capacity to respond to future challenges in the most efficient and equitable manner possible. Of course, we do not live in an ideal world.

Health systems around the world are incredibly inefficient and inequitable because the structure and function do not adequately match (and thus respond to) the burden. The activities of the various health systems actors are determined more by special interests (political, monetary, disease or population specific, etc.) than they are by the need to develop a system that is effective, efficient, and equitable.

While there are activists and advocates and stewards for diseases (AIDS, TB, diabetes, strokes, etc.) and populations (mothers, children, etc.), and special interests (pharmaceutical companies, physicians, politicians, etc.) there are few for the health system as a whole. We are all, however, health systems stewards. We all care about the health of our families and communities, and we all pay taxes that mold our health systems around the globe. We all want our health systems to be as effective, efficient, and as equitable as possible. We need, I think, to get organized and mobilized to respond to this tremendous need. See this blog for more about systems thinking and health.

(I came across the term “systems stewards” in the book Systems Thinking, page 92)


  1. That’s the crazy part about the health system, is yeah our world will never be ideal or perfect. Anytime you have 320 million people going into a new health system it will have many issues. You really cant create a one solutions fits all.

    • Jordan H said,

      I just found this website a couple minutes ago, and this is the first time I’m hearing about health systems. But I think the point of a health system is to take the 320 million people and put them into a system that is able to evolve and adapt according to the needs and culture of the people. The system won’t be ideal or perfect at first, but if the system has an efficient self correcting mechanism built in, then I think it could have the potential to be perfect someday. I guess our goal then is to come up with a system that has the most efficient and effective self correcting mechanism so that we can quickly identify and correct our mistakes. I think a system that self corrects is the solution that fits all because it’d adapt to fit all.

      What I just wrote sounds good to me right now, but I feel like I need to do some more reading on this.

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