ABSTRACT
Health system competes with all other social systems for achieving the goal of human welfare and contentment. Its importance lies in its capability to attain the above mentioned objectives to the maximum degree. Human and material resources are invested as inputs in every system for the purpose of getting maximum output in terms of human welfare. Resources are always limited and have to be utilized on priority basis in a manner that maximum attainment of final objective results. All social systems compete for [investment of resources] as inputs in the system concerned, but establishment of priorities for allocation of resources should be determined on the basis of expected outputs. The systems which give greater outputs in terms of attainment of ultimate objective of human welfare have to be given preference in terms of allocation of resources. In other words resources invested in a system must give output returns equal to the outputs given by other systems if input investments have to be justified. Otherwise less resources should be invested into such system, and the available resources should ordinarily be allocated to the system which can give better returns in terms of human welfare. Some conceptual framework and principles operate for determining priorities for various health programmes within the health system, Investments are determined on the basis of output returns. It is on the basis of the latter that evaluation of the programme is done. Input enumerations do not help in evaluating programme but only show whether the planned investment in the enterprise has been made or not. Health is a system and its working is complex. Health planning depends upon multiple factors besides the need, demand and the resources. A full understanding of the cybernetics of the health system is essential for good planning and successful management. Evaluation of the performance of the health system should be done on the basis of positive changes produced in community health indicators [expressing outputs of the system] and determination of the extent to which better health achieved has contributed to economic productivity and human welfare. The need for systems analysis and for determination of intermediate and ultimate objectives has been pointed out. Spelling out of health indicators and evaluation on the basis of change produced in them is essential for successful management of our health system. Need for operational research in this area and evolvement of new conceptional frameworks have not yet been fully recognized in Pakistan and is possibly putting a constraint on the speed of our progress