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This paper adopts the definition of health system by van Olmen et al. [ 22], which conceives the health system as consisting of governance and leadership, resources, service delivery, population, outcomes, and goals components.
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The 'health system dynamics' framework states that all ten elements are not equal: it emphasises a central axis between governance, human resources, service delivery and population.
The presented uncertainty ranges, particularly for ARV and DOTS, may be minimum intervals, which do not capture the complex chain of factors that intervene between service delivery counts, population coverage and impact, such as quality of services including (mis- diagnosis, drug quality, patient counselling and support to promis- diagnosisetention andrugeatment adherence.
In contrast to explanatory trials which operate under ideal conditions, pragmatic trials occur within the context of current service delivery and population needs, and ask "Does this intervention work under usual conditions?" [ 19] We are using a preference-based design [ 21] in which service preferences are elicited from mothers at the time that they are recruited to the study.
Resources that might otherwise be put into more surveys could be redirected to build local measurement capacity and improve critical service delivery for populations in need.
Higher general governance effectiveness is expected to have a negative relationship with incidence due to higher quality of service delivery to the population.
From it, Hamas will gain increased popularity among Palestinians, greater service delivery to Gaza population and greater capacity to challenge Abbas and Fateh in the West Bank.
Precedence of state institutions support over immediate, effective health service delivery can reduce population level results.
This was largely possible because each institution is also responsible for health service delivery to the population.
52 While further validation is required, these methods have the potential to transform service delivery for this population.
This study highlights the importance of monitoring and evaluating changes in health service delivery at a population level.
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