Many health system performance assessment frameworks have been developed over the years. Each with a particular aim and purpose with a slightly different conceptualization of the health system. For example, the behavioral health care framework was constructed to provide conceptually sound performance models based on theory. The WHO framework published in 2000 and the Commonwealth Fund framework published in 2006, were created in order to facilitate performance measurement and evaluation efforts. The Control Knobs framework published in 2003, the Systems Thinking framework and the International Health Partnership framework which were both published in 2008, were all constructed evaluate specific health system reforms. Well, the purpose of these frameworks may differ slightly. All frameworks go about achieving their ends by attempting to provide conceptual clarity in analytical, technical, and operational thinking for the different stakeholders involved. I will focus on four commonly used frameworks. The WHO 2000 framework, The Control Knobs framework, The Commonwealth Fund framework for high performing health systems, and the WHO 2007 Building Blocks framework. These frameworks have been around for a while. You'll see in the literature that they'd been utilized quite often. It's important to remember that there isn't a single best framework you can use, but rather a best fit for the purpose you intend to use it for. The WHO 2000 framework, the Commonwealth Fund framework, and the WHO Building Blocks framework are classified as analytical frameworks. While the Control Knobs framework is what is known as a deterministic framework. Analytical frameworks go beyond merely describing what exists in health system, to also analyze functional components of that system. This type of framework offers a more holistic and deeper analysis of the health system than purely a descriptive framework would. But does not really reveal the effectiveness of particular policies, reforms, or interventions, or even the interaction between the health systems various functions. Deterministic frameworks on the other hand, try to determine which factors influence performance of the health system in order to identify which reforms, interventions, or policies are most successful. Let's start with two of the analytical frameworks. First is the WHO health systems framework which was developed by Marine Frank in 2000. This framework attempts to provide a clear conceptualization of health system performance in terms of health system functions and goals. This framework was used in the World Health Report 2000 to measure the health system performance of a 191 member states. Which as you probably have heard have created quite a lot of controversy. As I mentioned, this framework is constructed in terms of health system functions. These are; service provision which is the organizational setting in which inputs and production processes are structured in order to deliver personal and non-personal health services. Financing, which is the organization, implementation, and management of collective revenues to allocate for provider activities. Resource generation, which is the generation of inputs such as human resources, physical resources, and knowledge needed to provide services. Finally stewardship, which is the umbrella under which the direction of the health system is defined. The second analytical framework I'll talk about is the Commonwealth Funds framework for a high performing health system. Which identifies a high-performance healthcare system as one that helps everyone to the extent possible lead long, healthy, and productive lives. A high-performance health care system has four main goals around which the framework is constructed. These are, high-quality safe care which means that care is provided in appropriate, safe, coordinated, responsive, and timely manner. Efficient care, which means that care is delivered at the right time and setting. This is done through efficient delivery and insurance systems with technologies, devices, products, and lab testing which are evaluated for effectiveness and values. Processes are put in place for their introduction, surveillance, retesting, and re-evaluation over time. Access and equity for all, which means care is affordable for the patient and the nation. It is provided equitably according to medical need and everybody has a minimum level of financial benefit. Finally, system and workforce innovation and improvement. Which means that the system is prepared to deal with shocks and significantly invest in innovation, research, and education with an infrastructure that supports transparency of information and accountability, but also balances autonomy and culture of improvement amongst professionals. Each of these four goals is made up of four or five criteria, upon which indicators can be mapped. You'll find the list of criteria in your readings so you can go through it in your own time. You've just heard about two analytical health system performance frameworks. The WHO framework published in 2000, and the Commonwealth Fund framework published in 2006. Next we'll move on to the last analytical framework, the WHO Building Blocks framework and the Control Knobs framework.