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Questions and Answers
What is a challenge in health governance?
According to the World Health Organization (2007), what does governance in health systems involve?
What is an aspect of stewardship in public health governance?
What is a function of public health governance?
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What is a responsibility of resources stewardship in public health governance?
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What is a challenge in health governance related to power?
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What is a part of policy development in public health governance?
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What is a key aspect of continuous development in health governance?
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What is the primary role of state actors in the health governance framework?
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What is a key feature of the relationship between citizens/clients and health providers?
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What is essential for achieving good governance in health systems?
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What is a key element of good governance in health systems?
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What is the role of health service providers in the health governance framework?
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What is a key aspect of partner engagement in health governance?
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What is the primary role of legal authority in health governance?
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The function of policy development in public health governance involves the alignment of budget with agency and people’s needs.
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Resource stewardship in public health governance involves not only human resources, but also financial, material, and legal resources.
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Good governance in health systems requires careful and responsible management of the well-being of the population.
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Health governance is only relevant at the national level.
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Stewardship in public health governance involves ensuring financial resources.
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The main challenge in health governance is the gap between requisite capacities needed to act upon good governance principles and available capacities within the country.
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Health governance only involves the healthcare sector.
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Health governance involves assessing health status and setting targets for quality and performance improvement.
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Citizens have no power in the health governance framework.
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State actors have no role in the health governance framework.
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Transparency is not an important aspect of good governance in health systems.
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Health service providers are not accountable to state actors.
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Partner engagement is not a key aspect of health governance.
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Legal authority has no role in health governance.
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Oversight is not an essential function of health governance.
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Study Notes
Challenges in Health Governance
- Gap between requisite capacities needed to act upon good governance principles and available capacities within a country
- Disparity between formal governance on paper and actual practice of governance
- Unequal degree of power among state actors, health providers, and citizens in health governance
Defining Governance in Health Systems
- Ensuring strategic policy frameworks, effective oversight, coalition building, regulations, incentives, system design, and accountability
- Governance is a function of stewardship, defined as careful and responsible management of population well-being
Functions of Public Health Governance
-
Policy Development
- Developing internal and external policies
- Adopting and enforcing regulations
- Developing vision, mission, goals, values, and measurable outcomes
- Setting priorities and strategic plans
- Monitoring and evaluating policies
-
Resources Stewardship
- Ensuring financial, human, material, and legal resources
- Developing cross-jurisdictional sharing of resources
- Aligning budget with agency and people's needs
- Engaging in sound fiscal planning
- Exercising fiduciary care of entrusted funds
- Advocating funding for public health services
-
Continuous Development
- Assessing health status and setting targets for quality improvement
- Supporting a culture of quality improvement
- Holding governing bodies and staff to high performance standards
- Examining agency structure, compensation, functions, and roles
- Providing ongoing professional development
-
Partner Engagement
- Representing a broad cross-section of the community and society
- Leading and participating in constructive dialogue on public health issues
- Serving as a strong link between health agency, community, and stakeholders
- Building linkages to mitigate negative impacts and emphasize positive impacts of health trends
-
Legal Authority
- Ensuring stakeholders act ethically within applicable laws and rules
- Ensuring provision of quality services to the population as mandated by law
- Engaging legal counsel as appropriate
-
Oversight
- Assuming responsibility for fulfilling mandated functions
- Evaluating job descriptions and professional competencies
- Maintaining good relationships to ensure health rules are administered and enforced
- Hiring and evaluating performance of staff
- Acting as go-between for health agency and elected officials
Health Governance Framework (Based on Principal-Agent Relationships)
-
Operational Model for Health Governance
- Good governance lies largely with state actors, but requires active engagement of other actors
- State actors, health service providers, citizens, clients, and civil societies are linked through principal-agent relationships
Key Features of State Actor and Provider Relationship
-
From State Actors to Health Providers
- Directives, resources, and oversight
- Objectives, procedures, and standards
- Resources and support
- Control and oversight
-
From Health Providers to State Actors
- Reporting and accountability
- Provision of information for monitoring and accountability
Key Features of Citizen and Health Provider Relationship
-
From Citizens/Clients to Health Providers
- Client power
- Collective action through civil society organizations
- Purchasing power of specific societal groups
-
From Health Providers to Citizens/Clients
- Services
- Provision of health services based on client needs, preferences, and demands
Assessing Governance in Health Systems
- Elements of good governance in health
- Encouraging participation and seeking consensus
- Providing strategic vision and policy design
- Addressing corruption and inefficiency
- Being transparent and accountable
Challenges in Health Governance
- Gap between requisite capacities needed to act upon good governance principles and available capacities within a country
- Disparity between formal governance on paper and actual practice of governance
- Unequal degree of power among state actors, health providers, and citizens in health governance
Defining Governance in Health Systems
- Ensuring strategic policy frameworks, effective oversight, coalition building, regulations, incentives, system design, and accountability
- Governance is a function of stewardship, defined as careful and responsible management of population well-being
Functions of Public Health Governance
-
Policy Development
- Developing internal and external policies
- Adopting and enforcing regulations
- Developing vision, mission, goals, values, and measurable outcomes
- Setting priorities and strategic plans
- Monitoring and evaluating policies
-
Resources Stewardship
- Ensuring financial, human, material, and legal resources
- Developing cross-jurisdictional sharing of resources
- Aligning budget with agency and people's needs
- Engaging in sound fiscal planning
- Exercising fiduciary care of entrusted funds
- Advocating funding for public health services
-
Continuous Development
- Assessing health status and setting targets for quality improvement
- Supporting a culture of quality improvement
- Holding governing bodies and staff to high performance standards
- Examining agency structure, compensation, functions, and roles
- Providing ongoing professional development
-
Partner Engagement
- Representing a broad cross-section of the community and society
- Leading and participating in constructive dialogue on public health issues
- Serving as a strong link between health agency, community, and stakeholders
- Building linkages to mitigate negative impacts and emphasize positive impacts of health trends
-
Legal Authority
- Ensuring stakeholders act ethically within applicable laws and rules
- Ensuring provision of quality services to the population as mandated by law
- Engaging legal counsel as appropriate
-
Oversight
- Assuming responsibility for fulfilling mandated functions
- Evaluating job descriptions and professional competencies
- Maintaining good relationships to ensure health rules are administered and enforced
- Hiring and evaluating performance of staff
- Acting as go-between for health agency and elected officials
Health Governance Framework (Based on Principal-Agent Relationships)
-
Operational Model for Health Governance
- Good governance lies largely with state actors, but requires active engagement of other actors
- State actors, health service providers, citizens, clients, and civil societies are linked through principal-agent relationships
Key Features of State Actor and Provider Relationship
-
From State Actors to Health Providers
- Directives, resources, and oversight
- Objectives, procedures, and standards
- Resources and support
- Control and oversight
-
From Health Providers to State Actors
- Reporting and accountability
- Provision of information for monitoring and accountability
Key Features of Citizen and Health Provider Relationship
-
From Citizens/Clients to Health Providers
- Client power
- Collective action through civil society organizations
- Purchasing power of specific societal groups
-
From Health Providers to Citizens/Clients
- Services
- Provision of health services based on client needs, preferences, and demands
Assessing Governance in Health Systems
- Elements of good governance in health
- Encouraging participation and seeking consensus
- Providing strategic vision and policy design
- Addressing corruption and inefficiency
- Being transparent and accountable
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Description
This quiz covers challenges in health governance, functions of governance in a health system framework, and principal-agent relationships in health governance.
