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  At Which Level is iHTP Used?  
From the administrative and clinical point of view, there are several levels of healthcare delivery: a national or tertiary level, a provincial level, a district level and finally, a primary care level. The various levels have different functions within a country’s healthcare system.

Primary care is seen as an "integral, permanent, and pervasive part of the formal health care system in all countries" or as the "means by which the two goals of health services system - optimization of health and equity in distributing resources - are balanced" (Basch P. Textbook of international health. New York, Oxford University Press, 1990). It addresses the most common problems in the community by providing preventive, curative, and rehabilitative services to maximize health and well-being. (Health Evidence Network, WHO Regional Office for Europe, www.euro.who.int/HEN/Syntheses/primaryvsspecialist). Tertiary care refers to highly specialized care given to patients who are in danger of disability or death often requiring sophisticated technologies (e.g., neurosurgeons or intensive care units). The intermediary levels such as provincial or district usually are within the sphere of influence of the local government. They provide healthcare which links local priorities with national health policies.

IHTP is developed for all different levels of healthcare. It ensures that the scope and complexity of healthcare technologies is realistic for any given level of healthcare delivery. The IHTP consists of a comprehensive map of all healthcare technology needs per intervention per healthcare level (Heimann, P., Kader, H. IHTP: Brief Technical Discussion, WHO, 2002). IHTP contributes to a clearer understanding of why the resources are needed at each level of healthcare delivery, in what quantities the resources are needed and how they fit together into an integrated healthcare system.

IHTP inherently bridges the gap between the planners at the strategic levels (national or regional), who may not have full knowledge of field realities, and practitioners at the operational level, who may be too immersed in their day-to-day clinical activities to be aware of the big picture. IHTP allows technology needs appropriate for each level of healthcare to be identified (Heimann, P. Planning Technologies for the Making Pregnancy Safer Initiative, WHO internal presentation, 2001); it thus facilitates the upward flow of information to be amassed into national requirements.


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