Management and Governance Paradigms in Health (SGHMANGOV) - HEALTH GOVERNANCE AND ACCOUNTABILITY
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Questions and Answers

What is a challenge in health governance?

  • Gap between requisite capacities needed to act upon good governance principles and available capacities within the country (correct)
  • Strong stewardship of public health resources
  • Strong formal governance that matches actual practice of governance
  • Equal degree of power among state actors, health providers, and citizens

According to the World Health Organization (2007), what does governance in health systems involve?

  • Only strategic policy frameworks and effective oversight
  • Combining strategic policy frameworks with effective oversight, coalition building, regulations, incentives, system-design, and accountability (correct)
  • Only setting priorities and strategic plans
  • Only developing internal and external policies

What is an aspect of stewardship in public health governance?

  • Only monitoring and evaluating policies
  • Careful and responsible management of the well-being of the population (correct)
  • Developing policies and regulations
  • Only ensuring financial resources

What is a function of public health governance?

<p>Developing internal and external policies (A)</p> Signup and view all the answers

What is a responsibility of resources stewardship in public health governance?

<p>Ensuring financial, human, material and legal resources (B)</p> Signup and view all the answers

What is a challenge in health governance related to power?

<p>Unequal degree of power among state actors, health providers, and citizens (C)</p> Signup and view all the answers

What is a part of policy development in public health governance?

<p>Developing internal and external policies, adopting and ensuring enforcement of regulations (D)</p> Signup and view all the answers

What is a key aspect of continuous development in health governance?

<p>Examining structure, compensation, functions and roles of the agency regularly (B)</p> Signup and view all the answers

What is the primary role of state actors in the health governance framework?

<p>Setting objectives, procedures, and standards (D)</p> Signup and view all the answers

What is a key feature of the relationship between citizens/clients and health providers?

<p>Client power through collective action (D)</p> Signup and view all the answers

What is essential for achieving good governance in health systems?

<p>Active engagement of all actors, including state actors, health providers, citizens, and civil societies (C)</p> Signup and view all the answers

What is a key element of good governance in health systems?

<p>Transparency and accountability (A)</p> Signup and view all the answers

What is the role of health service providers in the health governance framework?

<p>Providing health services based on client needs and preferences (A)</p> Signup and view all the answers

What is a key aspect of partner engagement in health governance?

<p>Representing a broad cross-section of the community and society (D)</p> Signup and view all the answers

What is the primary role of legal authority in health governance?

<p>Ensuring provision of quality services to the population (C)</p> Signup and view all the answers

The function of policy development in public health governance involves the alignment of budget with agency and people’s needs.

<p>True (A)</p> Signup and view all the answers

Resource stewardship in public health governance involves not only human resources, but also financial, material, and legal resources.

<p>False (B)</p> Signup and view all the answers

Good governance in health systems requires careful and responsible management of the well-being of the population.

<p>True (A)</p> Signup and view all the answers

Health governance is only relevant at the national level.

<p>False (B)</p> Signup and view all the answers

Stewardship in public health governance involves ensuring financial resources.

<p>True (A)</p> Signup and view all the answers

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.

<p>True (A)</p> Signup and view all the answers

Health governance only involves the healthcare sector.

<p>False (B)</p> Signup and view all the answers

Health governance involves assessing health status and setting targets for quality and performance improvement.

<p>True (A)</p> Signup and view all the answers

Citizens have no power in the health governance framework.

<p>False (B)</p> Signup and view all the answers

State actors have no role in the health governance framework.

<p>False (B)</p> Signup and view all the answers

Transparency is not an important aspect of good governance in health systems.

<p>False (B)</p> Signup and view all the answers

Health service providers are not accountable to state actors.

<p>False (B)</p> Signup and view all the answers

Partner engagement is not a key aspect of health governance.

<p>False (B)</p> Signup and view all the answers

Legal authority has no role in health governance.

<p>False (B)</p> Signup and view all the answers

Oversight is not an essential function of health governance.

<p>False (B)</p> Signup and view all the answers

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.

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