Although there have been clear improvements in the delivery of specific health services, many of the systemic problems facing the . child health system seem intractable and resistant to incremental reform strategies. Both the 1981 report of the Select Panel for the Promotion of Child Health and the 1991 report of the Na- tional Commission on Children highlighted numerous system-level problems re- lated to fragmented programs, disjointed and inadequate funding streams, inade- quate performance monitoring, and the lack of a coherent planning framework. 14 These problems have not been resolved. Arguably providing some of the finest medical care in the world, the . health care system still has not.
