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“National governments are ultimately responsible for the careful management of the well-being of the population” (World Health Report 2000). In the WHO European Region, national health ministries are responsible for the stewardship of their countries’ health systems. They set the vision for health system development, have the mandate and responsibility for legislation, regulation and enforcement of health policies, as well as for gathering intelligence on health and its social, economic and environmental determinants. Among other functions they have to ensure the health sector is properly governed at all levels based on prevailing values and is conducive to the attainment of health system goals.

Health ministries carry out six different types of activities as part of their health system stewardship capacity: they define a vision for health, and strategy and policies to achieve better health; they exert influence across all sectors of government and advocate for better health; they ensure good governance supporting the achievement of health system goals; they ensure the alignment of the health system design with goals pursued; they make use of legal, regulatory and policy instruments to steer health system performance; and they collect, disseminate and apply appropriate health information and research evidence.