Overview -- How health systems have evolved -- Potential to improve -- Providing better services -- Finding a better balance -- Protecting the poor -- Why do health systems matter? -- Changing landscape -- What is a health system? -- What do health systems do? -- Why health systems matter? -- How modern health systems evolved -- Three generations of health system reform -- Focusing on performance -- How well do health systems perform? -- Attainment and performance -- Goals and functions -- Goodness and fairness: both level and distribution matter -- Measuring goal achievement -- Overall attainment: goodness and fairness combined -- Performance: getting results from resources -- Improving performance: four key functions -- Health services: well chosen, well organized? -- Organizational failings -- People at the centre of health services -- Choosing interventions: getting the most health from resources -- Choosing interventions: what else matters? -- Choosing interventions: what must be known? -- Enforcing priorities by rationing care -- After choosing priorities: service organization and provider incentives -- Organizational forms -- Service delivery configurations -- Aligning incentives -- Integration of provision -- What resources are needed? -- Balancing the mix of resources -- Human resources are vital -- Adjusting to advances in knowledge and technology -- Public and private production of resources -- Legacy of past investments -- Health care resource profiles -- Changing investment patterns -- Way forward -- Who pays for health systems? -- How financing works -- Prepayment and collection -- Spreading risk and subsidizing the poor: pooling of resources -- Strategic purchasing -- Organizational forms -- Incentives -- How financing affects equity and efficiency -- How is the public interest protected? -- Governments as stewards of health resources -- What is wrong with stewardship today? -- Health policy: vision for the future -- Setting the rules, ensuring compliance -- Exercising intelligence, sharing knowledge -- Strategies, roles and resources: who should do what? -- What are the challenges? -- How to improve performance.