Framework for assessing governance
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This document presents a framework for assessing governance of health systems in developing countries. It discusses that governance is a key determinant of development outcomes and defines health system governance as the actions and means adopted by a society to organize itself to promote population health. The framework assesses governance based on nine principles: strategic vision, participation, rule of law, transparency, responsiveness, equity, effectiveness/efficiency, accountability, and intelligence. Governance is assessed at the national, policy formulation, and policy implementation levels using various information sources. The goal is to raise awareness of governance issues, inform policy, and identify financial costs of improving health system governance.
Framework for assessing governance
- 1. FRAMEWORK FOR ASSESSING GOVERNANCE OF HEALTH SYSTEM IN DEVELOPING COUNTRIES: GATEWAY TO GOOD GOVERNANCE Najibullah Safi, MD, MSc. HPM Reference: S. Siddiqi et al./Health Policy 90 (2009) 13-25
- 2. “… the exercise of political, economic and administrative authority in the management of a country’s affairs at all level” UNDP … comprises the complex mechanisms, processes and institutions through which citizens and groups articulate their interest, mediate their differences and exercise their legal rights and obligation Introduction
- 3. Introduction • Governance is a key determinants of: – Economic growth, social advancement and overall development – Governance of health system is the least well- understood aspect of health system • “Governance is perhaps the single most important factor in eradicating poverty and promoting development” Kofi Annan
- 4. • Health system governance concerns the actions and means adopted by a society to organize itself in the promotion and protection of the health of its population • Governance influences all other health system functions, thereby leading to improved performance and ultimately to better health outcomes Introduction
- 5. • Role of the state vs. the market in health • Role of the MoPH vs. other ministries • Actors in governance – public sector, civil society and the private sector • Static vs. dynamic health system Issues in the governance of health system
- 6. • Health system governance principles Strategic vision - Long term vision; comprehensive development strategy including health Participation and consensus orientation - Participation in decision making process; stakeholder identification and voice Rule of law - Legislative process; interpretation of legislation to regulation and policy; enforcement of law, and regulation Framework for assessing governance
- 7. • Health system governance principles Transparency - Transparency in decision making and allocation of resources Responsiveness - Response to population health needs at all level Equity and inclusiveness - Equity in access to care; fair financing of health care; disparities in health Framework for assessing governance
- 8. • Health system governance principles Effectiveness and efficiency - Quality of HR; communication processes; capacity for implementation Accountability - Internal and external accountability Intelligence - Information: generation, collection, analysis, dissemination Ethics - Health care and research ethics Framework for assessing governance
- 9. • Assessment levels National level (broader context) Policy formulation Policy implementation • Source of information Published report Unpublished report Interviews Framework for assessing governance
- 10. • Raising awareness • Policy implication of assessing each governance principle • Point out issues at all levels • Financial cost for improving health system governance Policy implication of assessing health system governance
- 11. QUESTIONS?
Editor's Notes
- #12: Microsoft Confidential