The first part of this course focuses on the principles and practice of health system analysis, the sources and utilisation of information relating to the development, organisation and operation of health services, and frameworks for assessing the performance of different health systems. Then, drawing on material from the health systems of affluent and developing countries, we examine the constitutional, legal, economic, social, and political environments within which health care systems operate and the various patterns that emerge. We review patterns of health service organisation and management: health policy development and planning; characteristics of personal, community and environmental health services and their activities; health service financing arrangements, including health insurance systems; and, the health workforce. The impact of some recent attempts at health system reform in different countries is assessed and proposals for future re-structuring are critically reviewed.