I think, you wish to assess the health care delivery system & if there are some lacunae, can be addressed. Before that one should know the strength, weakness, opportunities & threats. Where ever there's an issue that should be redressed. Under National Health Mission, the efforts are monitoring & evaluation of health care system through NQAS ( internal & external) is being done. For any system to evaluate, we should have good monitoring & supervision by dedicated supervisors. Good planning, nice observation,better supervision, proper direction , effective coordination, complete record & reports, efficient evaluation & judicious budgeting would be quite helpful in assessing the health care delivery system in a country.

This is a big question - it depends on your ambition, what you want to do. Smalle regions (small countries) may look at single syste, supplier (sy 1 to 2 million people). But this will always gve problems for the future - how to switch suppliers. Most large countries with strong public healthcare consider the longevity of the informtion and how to make a multi-supplier eco-system: this means using open standards for data transfers between systems and for persistance (I like to think of this as interoperability with the future). Countries with private healthcare (the USA) tend to have local (not country-wide) approaches: the privte healthcare providers like to keep hold of their patient data. They may aply open standards if they want a multi-supplier eco system, but their primary concern is their data (this is one part of why interoperability adption in the USA is slower than in Europe).

Once you have your oberall ambition set in place (like do you wonat medical records just for caring for patients, or maybe also for social care? or maybe also for population heath planning? for research?) then you can work on the more detailed criteria.

In terms of general criteria, I would say:

1. Patient/Person Centric information management

2. Build in management of privacy and consent with reespect to patient information (refer to you local laws)

3. Understanding what it means to share patient information with respect to you local laws (do you want to allow people to opt out of sharing for their own care and/or for secondary use/research?)

4. What conditions do you want to prioritise? Do you want to build disease registries?

5. Terminolgies - do you already have, or will you need to develop stnadardised terminologies and codification? Things like official codes for medications, diagnoses, diagnositc tests (radiology, labs)? The better the national frameowkr for terminologies the more meaning your data will carry.

6. What are the main disiease/conditions you need to manage in your country/region?

7. Clinical use - what are the scenarios where you envisage the data will be used? Who are the users? What will they need to support their clinical work?

Before you can assess health systems in multiple countries, you will need to know whether those countries all collect data that you think are important, do so in a comparable manner, and will make the data available to you. I do believe that for the countries you are interested in there are some data that can be compared - for example, neonatal mortality - and the data can be found online.

Thanks Godfred .

Gofres, thanks forma share. To evaluate health systems, I believe it is necessary to measure equity, both in terms of access to health services, and to assess the redistribution of health spending in the population.

I recommend that you compare the different healthcare systems for the different countries that you specified in your follow up question in relation to Ghana and West African Countries.

According to the UN Human Development Index - Ghana is ranked (140) and considered one of Medium Human Development - MHD countries while neighboring countries to Ghana and most of the countries in West Africa are categorized within the Low Human Development - LHD Index such as Côte d'Ivoire (171), Togo (166), Burkina Faso (185), Nigeria (152), Gambia (173), Sierra Leone (180) and Niger (187).

Based upon the above quick information, I recommend you compare the healthcare system within Ghana (31+Million) to Nigeria (206+ Million) to Côte d'Ivoire (26+ Million) and Niger (24 +Million), this will give you the opportunity to compare countries with similar population sizes.

As you know Healthcare Systems are affected by countries development, population and economic status to name a few.

I recommend you compare the following:

• Public Health Care Systems governing these countries;
• Role of the Private Health Care System in these countries;
• Private Public Partnership (PPP) initiatives within these countries and what they have achieved;
• Medical and Health Insurance Systems and Third Party Payers in these countries;
• Medical and Health Professional Educational Systems in these countries;

Then compare all these systems to the health outcomes of the population that are reported by the Ministries of Health of these countries and that are shared with the World Health Organization.

Definitely your approach to the study and how to compare the healthcare systems are related directly to the purpose of your study.

I hope I was of help and let me know if you need further input from my end.

The Commonwealth Fund does this for 11 countries and their reports are available online and might assist you

You may use the SWOT analysis, in line line with may thematic areas like available infrastructure, human recourse, available modern healthcare technologies, healthcare financing, competitive and comparative advantages and many others in relation to the other west African countries.