The design of health systems influences how the provision of services is organised. This may affect the use of services by different sections of the population. The provision of services may be fragmented, affecting accessibility, or some services may only be available to certain sections of the population. We, therefore, organise this chapter primarily along the lines of dimensions of system-determined aspects of accessibility of services: approachability, acceptability, availability, affordability, and appropriateness (Sects. 5.2–5.6). Not everything fits in easily; think of the benefit package and coverage, the public–private mix of service provision, the mix of human resources available, and the relations between sectors of care. However, we discuss them under the aspect of access that is most appropriate.