Health systems

Governance

Executive Board room at WHO, Geneva.

Governance in the health sector refers to a wide range of steering and rule-making related functions carried out by governments/decisions makers as they seek to achieve national health policy objectives that are conducive to universal health coverage. Governance is a political process that involves balancing competing influences and demands. It includes:

  • maintaining the strategic direction of policy development and implementation;
  • detecting and correcting undesirable trends and distortions;
  • articulating the case for health in national development;
  • regulating the behavior of a wide range of actors - from health care financiers to health care providers; and
  • establishing transparent and effective accountability mechanisms.

Beyond the formal health system, governance means collaborating with other sectors, including the private sector and civil society, to promote and maintain population health in a participatory and inclusive manner. In countries that receive significant amounts of external development assistance, governance should also be concerned with managing these resources in ways that promote national leadership, contribute to the achievement of agreed policy goals, and strengthen national health systems. While the scope for exercising governance functions is greatest at the national level, it also covers the steering role of regional and local authorities.

WHO is supporting countries in building the capacity needed to carry out governance functions effectively. This includes a better understanding of what constitutes best practice.