THE BOUNDARIES OF HEALTH SYSTEM: A PROPOSED MODEL

Background – Recently, the necessity of determining the boundaries of health system has been sensed by the World Health Organization. Accordingly, any set of activities whose “primary intention” is to improve or maintain health is defined as a health action. There remain various activities like “standardization of all industrial products” that are under debate to be determined as health actions. Considering the numerous concepts of “health” as the main source of controversy among health theorists, we designed a model to enable policy makers to delineate any given activity in a definite boundary of health system. We used a spectrum of health definitions for making the model. Methods and Results – All the definitions of health were classified in two major classes; a first class comprising of those parts of health concepts directly related to physical and mental health, and a second class containing those parts of health system pertaining to all types of health actions except physical and mental health including spiritual, sexual, societal, social, environmental, and emotional concepts. The organizations were theoretically divided into three layers: “primary organizations” are composed of core (the first layer) and satellite (the second layer) organizations and function in the first class of health definitions while the functions of the third layer (secondary organizations) fall within the second class. One can distinguish the core from satellite primary organizations by the extent of their contribution to mental and physical health activities. In the next step, we catalogued a list of organizations in the country with their official and published constitutions. Then, they were grouped into the three layers. Conclusion – Using this model, a policymaker can not only define the status of any set of activities within a definite health boundary, but she/he would also be able to allocate the available resources for a certain health problem to those organizations in each layer dealing with that problem.