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Governance

Challenge

A variety of problems that confront health systems relate to governance. These include, for example, financial management practices that permit corruption; unavailable information on planning, operations, and financing, thereby reducing accountability; lack of capacity of civil society and elected officials to hold health sector actors accountable; and failures of MOHs and local governments to engage stakeholders in health decision-making and priority setting.

Approach

The Health Systems 20/20 approach tackles both the demand and supply sides of governance. On the demand side, work with citizens and oversight entities inside and outside of government enhances capacity to exercise voice and accountability. These practices go hand-in-hand with strengthening the MOH and other health sector actors: the supply-side of governance improvement. Health Systems 20/20 promotes institutional arrangements that enhance the likelihood of positive results. Examples of such arrangements include decentralization, public-private partnerships, and checks and balances among health sector executive agencies, legislators, and accountability actors (auditors, courts, citizens’ groups).

Download Health Systems 20/20 and Governance brief.

New Brief!
Decentralization and Governance

Jun 30 2008

With almost all countries developing or implementing some form of decentralization, health initiatives targeting control of specific diseases, as well as projects that work on broader health systems restructuring, will be influenced by these decentralization efforts.

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Policy Brief
Health Governance: Concepts, Experience, and Programming Options

Mar 5 2008

A policy brief issued by Health Systems 20/20 on the threat that weak governance poses to the allocation of health resources in the developing world.

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Recent Health Governance Survey!

Jul 23 2007

Governance in the health sector is increasingly recognized as important to well functioning health systems and to the provision of quality services. While the application of good governance principles to health is becoming an increasing area of interest to members of the health community as they seek solutions to major health systems problems, there is still much that is not fully known about current governance practices in health. There are also major knowledge gaps with regard to the opportunities, priorities or entry points for strengthening health governance.

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Health Governance: Concepts, Issues, and Programming Options

Jun 13 2007

Health Systems 20/20 held a one-day workshop on Health Governance: Concepts, Issues, and Programming Options on June 13, 2007 in Washington, DC to:

  • Develop understanding of health governance concepts and practices within a framework that links the state, providers, and service users
  • Share experiences about health governance challenges, issues, and practices
  • Make recommendations for health systems programming in health and democratic governance
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Demystifying Health Systems: The Health Systems Assessment Approach

Apr 25 2007
April 25, 2007
1:00 - 3:00 pm
National Press Club

USAID asked its three major health system strengthening projects (PHRplus/Health Systems 20/20; RPM Plus; and the Quality Assurance Project) to develop a rapid but comprehensive approach to assessing health systems by drawing from their experiences working on different, but complementary components of health systems. The result of this effort is an indicator-based, modular assessment tool—Health Systems Assessment Approach: A How-to Manual. This seminar covered the contents of the manual, the circuitous path to its development, and a range of applications in Angola, Azerbaijan, Benin, Ghana, Malawi, Pakistan, and Yemen.

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