National programs for controlling HIV, TB and malaria require support from public and private organizations for health systems strengthening. This is based on the widespread basic premise that only through building and strengthening health systems will better health outcomes be secured. A health system is defined more broadly in this toolkit as

...all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities. A health system is therefore more than the pyramid of publicly owned facilities that deliver personal health services. It includes, for example, a mother caring for a sick child at home; private providers; behaviour change programmes; vector-control campaigns; health insurance organizations; occupational health and safety legislation. It includes intersectoral action by health staff, for example, encouraging the ministry of education to promote female education, a wellknown determinant of better health.

Further, the health systems strengthening service delivery areas in the toolkit are adapted from WHO’s framework for health systems strengthening (Fig. 8, page 281), which identifies six core building blocks: health workforce, information, medical products and technologies, financing, governance and service delivery. These six building blocks provide the foundation for discrete sets of measurements while acknowledging the links and interactions between each of them.