Health Systems Framework

The conceptual framework for the Swiss Learning Health System (SLHS) is given by the «health systems’ building blocks» as defined by the World Health Organization (WHO [1-3]) and the concept of the «learning health system» of the Institute of Medicine (IOM) and the National Academy of Medicine (NAM) in the United States [4-6]. Of particular relevance for developing the SLHS mechanisms is the systems thinking approach for health systems strengthening [2,3]. This approach highlights the dynamic architecture and interconnectedness of the health system building blocks and the role of people at the center of the health system, as mediators, beneficiaries, and drivers of the system.

  • Service delivery – effective, safe, quality personal and non-personal health interventions to those that need them, when and where needed, with minimum waste of resources
  • Health workforce – responsive, fair and efficient to achieve the best health outcomes possible, given available resources and circumstances
  • Health information system – production, analysis, dissemination and use of reliable and timely information on health determinants, health system performance and health status
  • Medicines and technologies – equitable access to essential medical products, vaccines and other technologies of assured quality, safety, efficacy and cost-effectiveness, and their scientifically sound and cost-effective use
  • Health care financing – adequate funds for health, in ways that ensure people can use needed services, and are protected from financial catastrophe or impoverishment associated with having to pay for them, with incentives for providers and users to be efficient
  • Leadership and governance – strategic policy frameworks combined with effective oversight, coalition building, regulation, attention to system design and accountability


  1. World Health Organization (WHO) (2007): Everybody's Business: Strengthening Health Systems to Improve Health Outcomes: WHO's Framework for Action. Geneva, WHO.
  2. De Savigny D, Adam T (eds) (2009): Systems thinking for health systems strengthening. Geneva, Alliance for Health Policy and Systems Research, WHO.
  3. van Olmen J, Marchal B, van Damme W, Kegels G, Hill PS (2012): Health systems frameworks in their political context: framing divergent agendas. BMC Public Health 12: 774.
  4. Institute of Medicine (2007): The Learning Healthcare System: Workshop Summary. Washington, DC: The National Academies Press.
  5. Institute of Medicine (2013): Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, DC: The National Academies Press.
  6. National Academy of Medicine (NAM). Learning Health System Series. See

Swiss Learning Health System
University of Lucerne
Department of Health Sciences and Medicine
Frohburgstrasse 3
6002 Lucerne
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