Accessibility, Efficiency and Quality of Care in Health Systems


  • The aim of this UNU International Institute for Global Health (UNU-IIGH) programme is to enhance health delivery systems in developing countries with the goal of achieving universal coverage. Development of an effective and efficient health financing system to ensure access to health services for high-risk populations is a priority. Capacity building through the development and deployment of a customized case-based payment using the Casemix system will be made available by UNU-IIGH in conjunction with its collaborating partners. Developing countries with limited manpower and financial resources will be able to use tools developed through this programme to deliver accessible, quality and efficient healthcare services. The Casemix Online Training Programme, launched in 2011, will provide greater access to UNU-IIGH capacity building programmes. Policy research on health biotechnology in developing countries is included to generate information on efforts to exploit domestic resources to sustain local health care industries.

    Focal Point

    The Accessibility, Efficiency and Quality of Care in Health Systems Programme will be led by UNU-IIGH Senior Research Fellow Professor Syed Aljunid.


    The overall aim of the programme is to support developing countries in achieving universal coverage through delivery of efficient, effective and accessible healthcare services.


    The programme will undertake collaborative research and capacity development activities with local and international partners. Workshops, seminars and conferences will be organized at local, regional and international levels, supplemented by e-learning package.


    Women researchers will be encouraged to participate in the various projects to ensure gender balance in the programme.

    Target Audience

    The stakeholders in the programme will include national health policymakers, local communities, community leaders and local and regional authorities international donors, other UN Agencies including World Health Organisation, the United Nations Development Programme and UNICEF.

    Intended Impact

    Impact: Influencing policymaking at the international level
    Target: Sharing of information and experience on the use of casemix system in countries in the region
    How: Publications, regional seminars and conferences.

    Impact: Influencing policymaking at the regional level
    Target: Interactions with Senior officers of Ministry of Health and Social Health Insurance Agencies in each country.
    How: Meetings, seminars and policy dialogue with national level leaders

    Impact: Capacity development in developed/developing countries
    Target: Health workers in public and private health care facilities and staff of social health insurance agencies.
    How: Capacity building workshops and the Casemix Online Training Programme

    Research Findings

    Implementation of the Casemix system has been shown to improve efficiency and the quality of healthcare services. Health information systems were the first to benefit from the Casemix system, and the accuracy of clinical information on patient diagnosis and procedures is shown to improve with its use. Clinical pathways developed during the implementation of Casemix have been proven to reduce the variation of care and improve the outcome of services. The coefficient of efficiency in hospital services was shown to increase between at least 1% to 1.3% per hospital unit/department per year with the use of the system.

    Policy Bridging

    Data on the benefits of the Casemix system to social health insurance schemes is emerging. Experience on the gain in efficiency, quality and improvement to health information systems for effective decision-making will help to support policy on implementation of prospective payment methods for reimbursement of health providers funded by social insurance programmes.

    Value Added

    Universal coverage and efficient management of health financing systems are important targets set by health-related UN agencies. Through this programme, UNU-IIGH provides an affordable tool to be used to improve performance of health financing systems. This programme will enhance accessibility, efficiency and quality of health care in developing countries by providing inputs to existing policies and building human capacities.


    Outputs of the programme include research reports, paper presentations at national and international conferences, journal publications and capacity-building of local expertise. The output will be disseminated through presentations in local and international seminars, workshops and conferences and publications in scientific reports and journals.

    Timeline/Programme Cycle

    Activities in this programme will be conducted throughout the two-year period covered under this biennium.


    Activities will be evaluated by assessing changes in knowledge monitored to ensure progress through meetings, workshops and progress reporting.


    The challenges include the lack of health infrastructure necessary to taking on the new approaches developed in the programme, lack of human resource capacity and financial constraints.

  • Title: Implementation of the Casemix System in Developing Countries Report
    Author(s): Syed Aljunid, Amrizal M Nur, Zafar Ahmed and Shariffah Ezzat
    Publication/Output Type: Report on project implementations and journal articles describing the experience and impact of the Casemix system implementation on health systems of selected developing countries.

  • Dr. Mohamed Salleh Mohamed Yasin, Director
    United Nations University
    International Institute for Global Health
    HUKM Complex
    Faculty of Medicine
    Universiti Kebangsaan Malaysia
    Jalan Yaacob Latiff
    56000 Cheras
    Kuala Lumpur, Malaysia

    T: +60 3 9171-5394
    F: +60 3 9171-5402