Strengthening health system governance: better policies, stronger performance (2015)



Edited by: Scott L. Greer, Matthias Wismar and Josep Figueras
Published by Open University Press
European Observatory on Health Systems and Policies Series
2015, xiv + 272 pages
ISBN 978 0 3352 6134 5

Governance is the systematic, patterned way in which decisions are made and implemented. The governance of a health system therefore shapes its ability to respond to the various well documented challenges that health systems face today, and its capacity to cope with both everyday challenges and new policies and problems.

This book provides a robust framework that identifies five key aspects of governance, distilled from a large body of literature, that are important in explaining the ability of health systems to provide accessible, high-quality, sustainable health: transparency, accountability, participation, organizational integrity and policy capacity. Part 1 of this book explains the significance of this framework, drawing out strategies for health policy success and lessons for more effective governance:

  • transparency, accountability, participation, integrity and capacity are key aspects of health governance and shape decision making and implementation;
  • there is no simply good governance that can work everywhere: every aspect of governance involves costs and benefits, and context is crucial; 
  • governance can explain policy success and failure, so it should be analysed and in some cases changed as part of policy formation and preparation; and
  • some policies simply exceed the governance capacity of their systems and should be avoided. 

Part 2 explores eight case studies in a number of different parts of the WHO European Region, applying the framework to a range of themes including communicable diseases, public–private partnerships, governing competitive insurance market reform, the role of governance in the pharmaceutical sector, and many more.

This book is designed for health policy-makers and all those working or studying in the areas of public health, health research or health economics.