Libyan National Health Services The Need to Move to Management-by-Objectives

Abstract

In the last four decades, there has been a substantial horizontal expansion of health services in Libya. This resulted in improvement in morbidity and mortality, in particularly those related to infectious disease. However, measures such as the national performance gap indicator reveal an underperforming health system. In this article, we discuss aspects related to the Libyan health system and its current status including areas of weakness. Overcoming current failures and further improvement are unlikely to occur spontaneously without proper planning. Defining community health problems, identifying unmet needs, surveying resources to meet them, establishing SMART (specific, measurable, achievable, and realistic and time specific) objectives, and projecting administrative action to accomplish the proposed programs, are a must. The health system should rely on newer approaches such as management-by-objectives and risk-management rather than the prevailing crisis-management attitude.

Keywords: Health Services; Health crisis; Health reform; Libya; Management-Quality.

Figure 1

The steady decline in child mortalities indicators related to overall socioeconomic conditions [IMR Infant mortality rate and U5MR underfive mortality rate] versus nearly constant level of child mortality indicator related to quality of health service [NNMR neonatal mortality rate] in Libya during the period 1964–2004.

Figure 2

Secular trend in notified cases of tuberculosis and leprosy in Libya during the period 1972–2005.

Figure 3

National performance gap scatter plot showing children mortality in some chosen countries in relation to per-capita gross domestic product. [SY: Syria, SA: Saudi A, RS: Serbia, MT: Malta, LY: Libya, IT: Italy, HU: Hungry, FJ: Fiji, CU: Cuba, CM: Cameroon, UT: Australia, DZ: Algeria, AF: Afghanistan]. Higher mortality or intermediate mortality in spite of higher income depicts low performance systems.