[MUSIC] You might be planning a trip to another country and you'd like to know what sort of health system the country you plan to visit has, in case you're unwell or need to seek medical care. Or maybe you're part of a public health task force, responsible for reviewing the performance of a given health system to make recommendations for reform. Or perhaps you simply would like to know which health system is the best performing globally. To help you answer any or all these questions, you need to learn about what is meant by health system performance, how it can be assessed, and why, which will be covered here. Performance measurement evaluates the extent to which a health system meets its key objectives. It often focuses on the common dimensions of measurement, such as improvement of population health, responsiveness, financial protection, equity, and efficiency. So why is this important? Because performance information is used to demonstrate whether a health system is able to improve the health of its population. Performance information also helps to promote transparency, accountability, and to determine appropriate treatments for patients to facilitate patients choice. And even allow stakeholders to make international comparisons. Whatever the ultimate aim of collecting performance information, users of this information need to be able to understand what data are being collected, and how this data relates to the health system architecture and its performance. Over the years, as health system performance measurement develops and various frameworks are produced, there has been considerable variation and often confusion as to what is being measured. A clear conceptual framework help clarify the way in which stakeholders understand health systems. When considering how good health system is, in terms of its performance, the distinction between a conceptual health system framework and a health system performance assessment framework is important. As you have already heard earlier in this course, a conceptual framework is a framework that defines, describes, and explains the health system, its objectives, its functions, and its processes. An example of this would be the WHO Health System framework or the WHO building blocks framework. A performance assessment framework, however, is an actionable performance assessment tool that can be used to map performance information back to the health systems objectives, functions, and processes. It can therefore be used to assess and evaluate the performance of the system. As you may have figured out, a good conceptual framework can provide the basis of a performance assessment framework. This means that conceptual frameworks can often lend themselves to becoming suitable performance assessment frameworks, regardless of whether this was their intended purpose. However, frameworks that are created specifically for performace assessment purposes may not always be good conceptual farmeworks. Giving that they do not provide a clear conceptualization of how these objectives fit back into the house system architecture. Frameworks are create specifically for performance assessment purposes are often classified as monitoring and evaluation frameworks, which, as the name suggests, outlines areas in which systematic monitoring and evaluation of progress is undertake. A health system performance assessment framework, by definition is constructed to evaluate performance. And thus will have a more developed method, which allows it to measure how well the health system is performing. How well a framework is able to evaluate will depend on how explicitly the framework defines good performance and even performance. Performance in this context is commonly understood to reflect the attainment of health system goals and objectives. Next, you'll learn about how health system goals and objectives are considered when evaluating the performance of a health system through the use of data in indicators. In summary, performance measurement evaluates the extent to which a health system meets its key objectives. Performance information is used to demonstrate whether a health system is able to provide improved health to its population, promotes transparency and accountability, and helps determine appropriate treatments for patients. And finally, a conceptual health system framework can lend itself to becoming a suitable performance assessment framework, while frameworks that are created for performance assessment purposes may not always make a good conceptual framework. [MUSIC]