me to pay for health care, budgets that allocate money to health entities (in a) and indirect costs that families incur when they access health services.
#### f. **Governance and National Policy**
All the pieces of a health system are held together by governance arrangements, policies and regulations that identify the roles and responsibilities of the major players and define how health resources will be used to deliver health services to a population.
### 2. **Challenges Facing Health Systems**
Numerous challenges face health systems. For example, the widespread impact of Covid-19 on health systems is just now being fully understood. Health systems, as they were, will never be the same – millions of people without essential services, a projected decrease in life expectancy, more people with chronic disease, dramatic changes in the workforce and how care is delivered.
Other major challenges include:
– Changing population demographics and patterns
– Misidentifying and missing opportunities for preventative health
– Disrupted systems of interdependence (e.g. health and education)
– Inequitable access to radius or proximity to health services
– Cultural diversity in health care supply chain
– Variation in health systems
– Limited appraisals of emerging health technologies
– Health human resources shortages
– Variability in health service volumes and funding
– Uncertainty and instability in budgets for organizations and the finance of the health services.
### 3. **Directions for the Future of Health Systems**
The future of health systems begs the question of the shape they will take; which will also depend on what crises may or may not materialize.
Health systems can be co-produced with the population, using an asset-based approach, to build relationships of trust and effective dialogue to develop health service delivery models that equip and empower communities to take care of their own health.
Compared to the deficiencies in the healthcare system that existed prior to the pandemic, the health systems of today and into the foreseeable future have an opportunity to better address collective and collaborative health care needs, and yet still address historical gaps in care needs previously ignored and/or misplaced.
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