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. 2022 Oct 31;10(5):e2200023. doi: 10.9745/GHSP-D-22-00023

TABLE 1.

Health System Functions Drawn From the VSM, With Illustrative Assessment Areasa

Functions and Corresponding VSM Systems Illustrative Assessment Areas Number of Questions in VAT 
Service delivery (System 1)
  • Staffing levels

  • Motivation and skills of needed staff

  • Inclusion of approach in existing staff job descriptions

3
Coordination (System 2)
  • Coordination of services between SDPs to ensure a full package of care

  • How clients and information move between SDPs, within and outside the facility, and to community providers

7
Supervision, management, oversight, control (System 3)
  • Supervision tools for SDP and system managers

  • Clarity of supervision approaches and processes

  • Applicability of existing supervision procedures to the proposed approach

5
Higher-level management/planning; policy and governance (Systems 4 and 5)
  • Management structures in place (within SDPs, at the facility, and within the subnational unit) to ensure effective service provision

  • Operationalization of national-level policies and standards at subnational, facility, and SDP units

2
Support systems: Supply chain
  • Systems supporting commodity and supply management

3
Support systems: Information systems
  • Availability and accessibility of information on service delivery, support systems, and operations to SDP (and system) managers

  • How information is used in day-to-day and higher-level decisions

3

Abbreviations: SDP, service delivery point; VAT, Viability Assessment Tool; VSM, Viable Systems Model.

a See Supplement 2 for further detail about the adaptation of the VSM to the health system context.