The Health Systems Planning & Governance Platform: thinking about health systems governance and how it can be used to improve population health

HSGP blog

 

Is “health systems governance” becoming the new buzzword in global health? While an increasing number of academic papers are being published on this theme, each trying to lay down the theoretical and foundational elements of what health systems governance is and what it can possibly mean in practice, ideas such as “good governance” or “governance for UHC” are seemingly entrenching themselves and developing roots in the global health discourse.

But what exactly is governance? In the field of international development, the concept is not new. It has been with us since the late 1980s, when the World Bank first coined it in what they called the “crisis of governance” in many Sub-Saharan African countries. But as many critics would point out, governance is an elusive concept; it can be used to mean everything and nothing.

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#FeaturedResource

Featured Resource: Practicing governance towards equity in LMIC health systems

A collection of papers in the International Journal for Equity in Health that explores the everyday practice of governance in the health systems of low- and middle-income countries.

  1. Helen Schneider and Nonhlanhla Nxumalo
    Leadership and governance of community health worker programmes at scale: a cross case analysis of provincial implementation in South Africa (Creative Commons licence, no changes made)
  2. Ermin Erasmus, Lucy Gilson, Veloshnee Govender and Moremi Nkosi
    Organisational culture and trust as influences over the implementation of equity-oriented policy in two South African case study hospitals (Creative Commons licence, no changes made)
  3. Aku Kwamie, Miriam Asiamah, Marta Schaaf and Irene Akua Agyepong
    Postings and transfers in the Ghanaian health system: a study of health workforce governance (Creative Commons licence, no changes made)
  4. Benjamin Tsofa, Catherine Goodman, Lucy Gilson and Sassy Molyneux
    Devolution and its effects on health workforce and commodities management – early implementation experiences in Kilifi County, Kenya (Creative Commons licence, no changes made)
  5. Kerry Scott, Asha S. George, Steven A. Harvey, Shinjini Mondal, Gupteswar Patel and Kabir Sheikh
    Negotiating power relations, gender equality, and collective agency: are village health committees transformative social spaces in northern India? (Creative Commons licence, no changes made)
  6. Vera Scott and Lucy Gilson
    Exploring how different modes of governance act across health system levels to influence primary healthcare facility managers’ use of information in decision-making: experience from Cape Town, South Africa (Creative Commons licence, no changes made)
  7. Benjamin Tsofa, Sassy Molyneux, Lucy Gilson and Catherine Goodman
    How does decentralisation affect health sector planning and financial management? a case study of early effects of devolution in Kilifi County, Kenya (Creative Commons licence, no changes made)
  8. Mary M. Nyikuri, Benjamin Tsofa, Philip Okoth, Edwine W. Barasa and Sassy Molyneux
    “We are toothless and hanging, but optimistic”: sub county managers’ experiences of rapid devolution in coastal Kenya (Creative Commons licence, no changes made)
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Looking back to move forward: Reflections from the Health Policy and Systems Research Conference - 20 Years On

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Amanda Edwards, Anne Mills and Lucy Gilson at the conference in Stockholm, Sweden

It was my enormous privilege to attend the 20th anniversary of the formation of the Alliance for Health Policy and Systems Research (AHPSR). Hosted by the Swedish International Development Cooperation Agency, the conference was attended by a broad range of health policy and systems research (HPSR) stakeholders, including a number of multinational funding agencies and researchers from around the globe.

The event was held in Stockholm, Sweden, where the Alliance was established in 1997. The conference served as an important milestone for the Alliance, allowing the opportunity to reflect on the successes and challenges of the last 20 years, and to develop plans and strategies for meeting the ambitious goals of Agenda 2030 in a global health climate that is increasingly complex and unpredictable.

I was invited to attend the conference as the representative of the writing team awarded first prize in the first AHPSR essay competition on the “Future of Health Policy and Systems Research.” The paper, written in collaboration with fellow students* in the Masters in Public Health at the University of Cape Town, sought to describe the challenges faced by global health policy and systems researchers, and explore the potential and possibilities for the Alliance and the field of HPSR from a Southern perspective. The theme of the essay allowed us to explore issues we felt passionate about, and explicate these issues from our own perspective. Little did we realise that these ideas would resonate so deeply with members of the Alliance. I was invited to present the essay in the opening plenary of the conference, alongside HPSR pioneer, Dame Anne Mills.

In this blog, I offer some personal reflections on the experience, and draw out key issues arising from these two days of intensive, reflexive and engaging debate.

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Stirring it up! Collaboration between quantitative and qualitative researchers

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The author (left) and the rest of his project group 

The mixed methods approach has only recently been conceptualised,[1] but for decades public health researchers have been combining qualitative and quantitative research methods in their studies. Both qualitative and quantitative methods provide a distinctive kind of evidence. When put together, they can complement each other and generate persuasive evidence that can influence both policy and practice[2]. However, collaboration between qualitative and quantitative researchers can be challenging.

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