Sn1. Introduction: 1. A system approach to health services -- 2. Challenges facing health services -- 3. Formal and lay care -- Sn2. Inputs to health care: 4. Diseases and medical knowledge -- 5. Medical paradigms -- 6. Staff: the challenge of professionalism -- 7. Funding health care -- Sn3. Processes of health care: 8. The need and demand for health care -- 9. The relationship between need and use -- 10. Staff-patient interactions -- 11. Public as consumers and policy -- Sn4. Outcome of health care: 12. Outcomes -- Sn5. Organization of services -- 13. Analysing health systems -- 14. Why are health systems as they are? -- 15. Low and middle income countries: from colonial inheritance to primary care -- 16. Low and middle income countries: from comprehensive primary care to global initiatives -- 17. Health services in high income countries -- Sn6. Quality improvement: 18. Defining good quality health services -- 19. Performance assessment -- 20. Improving quality of care.