this reorganisation of service delivery must be underpinned by a clearer vision of the future health system architecture and implemented more systematically beyond delivering the appropriate volumes of services attention must be paid to embedding quality improvement initiatives in health professionals practices at all levels of the system finally the availability relevance and quality of information and evidence must improve and all health system actors health professionals local and national providers local and national units of authority need to be held accountable for the outcomes of their actions and results with a population of only million in the th largest and largest landlocked country it is one of the least densely populated nations in the world