Health Systems Research Shapes Governance Impact

This post also appears on the LMG for Health blog.

There is a growing pool of studies that good governance matters as “The Big Enabler” for health systems strengthening.

Health systems researchers in the Capetown, South Africa, Third Global Symposium on Health Systems Research explore the theory of change that guides governance interventions: a solid governance infrastructure enables sound management of health systems, which increases the probability that health services will be better used and health outcomes will improve.

Both policy makers and health service providers have become interested in how good governance increases the probability that health services will be better used for better health outcomes.

But why do they believe that?
How is it possible that better governance can yield better health?
I think the short answer is… it cannot UNLESS certain conditions are available. Conditions like:
  • structures for governance decision-making (governing bodies of various types and sizes) that have clear terms of references and effective leadership;
  • participants in the governing processes that understand their roles and responsibilities;
  • decision-making processes that understand and effectively accomplish the 4+1 practices of:
    • create a culture of accountability;
    • engage diverse stakeholders;
    • set strategic directions;
    • steward scarce resources; and then
    • continuously improve the above practices.
  • leadership staffing that supports and enhances the work of the governing bodies;
  • enough resources that allow governing decisions to actually get implemented; and
  • a context and culture that has rule of law and ethics that demand results and transparent decision-making.
Where is the evidence that smart governance matters?
These substantial studies show the power and value of good governance to enable the work of those who deliver, manage and lead health services organizations:

Photo Blog: Day 1 of the Global Governance for Health Roundtable

This post is cross-posted from the LMG for Health blog.

From September 29th – 30th, over 50 thought leaders in global health are gathering in Cape Town, South Africa for the Third Global Governance for Health Roundtable. The Leadership, Management & Governance (LMG) Project is collaborating on the Roundtable with the Health Policy Project and the Health Finance and Governance Project.

On the first day of the Roundtable, topics covered ranged from measuring the value of governance, including vulnerable populations in governance, and case studies on decentralization in Kenya and Afghanistan.

Ayanda Ntsaluba (right) Executive Director of Discovery Health and Former Director-General of Health for South Africa, welcomes participants to the Third Global Governance for Health Roundtable.

Participnat Eunice Seekoe. Head of the School of Health Sciences at the University of Fort Hare, South Africa.


Chantal Uwimana, Regional Director for Africa and the Middle East for Transparency International, moderates the session, “Transparency, Accountability, and Trust: Bridges to more Equitable Access to Services,” which included panelist Jeremy Kanthor (left) Governance Advisor for the Health Finance and Governance Project.

Participants engage in a lively discussion including Barry Kistnasamy the Compensation Commissioner for South Africa’s Department of Health (center).


Tshepo Kgositau, Regional Coordinator for Gender DynamiX, delivers comments for the session, “Inclusion: Engaging Vulnerable and Marginalized Populations in Governance for Health Gains.”


Panelist for “Politics and Health Governance: Strategies for Ensuring Commitment to Health Systems.” From left:  Derick Brinkerhoff, Distinguished Fellow in International Public Management, RTI International, Health Policy Project (HPP);  Anele Yawa, Representative, Treatment Action Campaign;  Aaron Mulaki, Health Systems/Public Administration Advisor, HPP/Kenya, RTI International; Christopher Tapscott, Director, School of Government, University of the Western Cape; and Robert Ndieka, Monitoring and Evaluation Expert, African Union Commission.

LMG to host Third Global Governance for Health Roundtable

Good governance is essential to strengthening health systems and has the ability to greatly impact health services utilization and health outcomes. The Leadership, Management & Governance (LMG) Project is hosting the Third Global Governance for Health Roundtable to bring together thought leaders from across the world to explore trends and practices for good governance within the health sectors of low- and middle-income countries.

Photo Credit: Todd Shapera, 2013

Photo Credit: Todd Shapera, 2013

The two day event, held in Cape Town, South Africa, is organized in collaboration with the Health Finance and Governance (HFG) Project, and the Health Policy Project (HPP), and will address the following six themes:

  • Generating Evidence for Action: Measuring the impact of governance
  • Advancing health equity and access to health services through good governance
  • Inclusive Governance: Meaningful engagement of women and traditionally marginalized populations
  • Politics, policy, and effective governance for health
  • Governing in Decentralized Health Systems: Case studies from the field
  • Donors: Investing in good governance for health

The insights from the invite-only roundtable will be reported out at the Third Global Symposium on Health Systems Research at the Cape Town International Conference Centre. Please join us on Wednesday, October 1st from 4:30 – 6:00pm (room 1.63-1.64) in the session titled, “Governance that enables evidence for stronger health systems and greater health outcomes,” Dr. James Rice, Project Director, Leadership, Management & Governance, will moderate the session discussing:

  • breaking through the challenge of measuring the impact of good governance
  • the power of effective women engagement in modern governance arrangements for health services delivery and finance in the journey to UHC and equity
  • lessons about governance practices that unleash more significant and more sustainable health services research for health systems performance

Attending the Third Global Symposium on Health Systems Research? Check out the full schedule of LMG events or follow live updates on Twitter and Facebook.

Proceedings from the previous two Global Governance for Health Roundtables are available here. For more information, please contact Sarah