Governance and management of public health programmes

Abstract

Governance is central to improve health systems performance and achieve Universal Health Coverage. Good governance can enable the effective use of health finances, workforce, medicines, and information to deliver better health services and outcomes. Theories of principal-agent and network governance are introduced to better understand health governance at system level. In health governance system, the government, private sector, and civil society are the governing triangle, and form a whole-of-society governance approach for health. We introduce the governing triangle and its role in health governance, governance mechanisms and tools, and the levels of governance, respectively. The triangle plays health governance functions at four levels to collectively pursue health goals: the supranational or national or organizational or programme levels. At each level, tools of governance are central to health governance functions and enabling relationships among triangles. Tools of governance can be classified into nine governance dimensions: accountability, regulation, participation, and consensus in decision-making, formulating policy/strategic direction, organizational adequacy/system design, generating information/intelligence, partnerships for coordination and collaboration, engagement of community, communication, and transparency. Assessment frameworks are further introduced for evaluating whether health governance is effective. And several cases of health governance are introduced for better understanding.