Governance

As awareness of the role governance in the performance of health systems has increased, so has the need to come up with systematic means to evaluate governance shortcomings to develop adequate interventions.

This working paper describes a framework to assess governance in the health systems of low-income countries that is intended to have empirical applicability with a problem-driven approach. The analysis is grounded on a re-categorization of governance dimensions for greater heuristic power, with an emphasis made on the importance of strategic systems design and accountability.

The proposed methodology includes mapping of both formal and informal institutions, actors and networks. This underscores the idea that in order to properly address governance weaknesses it is of utmost importance to have an insight into whether the interplay of formal and informal norms facilitates or undermines system performance.

About this Working Paper

Strengthening accountability in public service provision is increasingly recognized as a precondition to improve the performance of the health sector in low-income countries. However, progress in this field has been hampered to a great extent because of empirical difficulties in measuring and assessing accountability.

This article provides a clear operational definition of the concept and discusses how and why accountability in public health service provision presents distinct challenges to the institutional capabilities of most developing countries. On the basis of both elements a set of guidelines to empirically assess accountability in health services is offered.

About this Working Paper