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While these are the overall goals of the health system and as such should be reflected in countries' national health strategies, HSS strategies, being an integral part of national health strategies, often address more specific objectives, fulfilment of which cumulatively contributes to achieving the broader health system goals.
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This paper analyses these mechanisms, their implementation in Spain by means of RD 661/2007 and the degree of fulfilment of objectives.
To use an educational analogy, medical schools may demonstrate ability and competence in the test circumstances of accreditation, but the appropriate measures of outcome as fulfilment of objectives are evaluation of performance and quality.
In family medicine, unlike other hospital specializations, each resident has an assigned tutor in the health center work alongside them through their residence and supervise the fulfilment of objectives as part of a learning evaluation that identifies possibilities for improvement and proposes corrective measures, with constant feedback in continued active tutoring meetings.
GPs are salaried and their payment is composed of two parts: a larger fixed remuneration and a small one (less than 10% of total) based on the number of patients assigned to their lists of patients; there are no financial incentives to the physicians for the number of visits they provide nor the fulfilment of objectives, such as restraints in prescriptions expenditure or number of referrals.
Fulfilment of project objectives was demonstrated by a programme of post-installation noise measurements.
Fulfilment of these objectives can primarily be assessed when the building is in use.
Practical fulfilment of such objectives requires a painting model applicable for an arbitrary spray-gun's position, orientation and velocity.
The fulfilment of the objectives of PBSD requires number of collapse simulations of a building equipped with certain type of seismic force resistant system.
The 14-item MD Adherence Questionnaire will be used to assess the implementation of the intervention, support provided, and fulfilment of project objectives.
In fulfilment of its objectives and in accordance with the Ministry's interest, both UNICEF and the Ministry of Youth agreed to join efforts to conduct a participatory review of the activities in the Ministry's centres.
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