Strengthening service delivery is crucial to the achievement of the health-related Millennium Development
Goals (MDGs), which include the delivery of interventions to reduce child mortality, maternal mortality and
the burden of HIV/AIDS, tuberculosis and malaria. Service provision or delivery is an immediate output of the
inputs into the health system, such as the health workforce, procurement and supplies, and financing. Increased
inputs should lead to improved service delivery and enhanced access to services. Ensuring availability of health
services that meet a minimum quality standard and securing access to them are key functions of a health system.
To monitor progress in strengthening health service delivery, it is necessary to determine the dimensions along
which progress would be measured. Box 1.1 sets out eight key characteristics of good service delivery in a
health system. These ideal characteristics describe the nature of the health services that would exist in a strong
health system based on primary health care, as set out in the 2008 World Health Report (1).
• health systems performance assessment, as the key for country decision-making processes; and
• evaluating the results of health reform investments and identifying which approaches work best.