ABSTRACT
@#The paper by Bernal-Sundiang et al.1 in this issue of Acta Medica Philippina provides one of the more extensive and in-depth empirical discussion of governance in the health sector. Utilizing data collected over a one-year period as part of the Philippine Primary Care Studies in urban, rural, and remote settings, the authors reported on challenges their team encountered in project implementation as it relates to leadership and governance. One strength of the paper is that it situates leadership and governance as a health system keystone that links to all the other components of infrastructure and supply chains, information system, health workforce, financing, and stakeholder engagement, and monitoring and evaluation. This harks back to the framework posited in the World Health Report 20002, highlighting the interaction between governance and the other system elements. Despite this critical role of governance, however, it has been characterized as being poorly understood, and often difficult to operationalize, not least because of poor capacities of different institutions and actors to bring to the fore the good governance agenda.3 For instance, it has been suggested that good governance, regardless of the sector, is “accountable, transparent, responsive, equitable and inclusive, effective and efficient, participatory, consensus-oriented and follows the rule of law.”4 This characterization assumes the existence of traditions and institutions that places the common good front and center, something which may not be present, if not willfully disregarded, in many jurisdictions. Another set of related buzzwords for governance is that it entails a “whole-of-government” and “whole-of-society” approaches, which means the mobilization of public agencies, on the one hand, and private sector and civil society organizations, on the other, towards the realization of shared goals.5 Aside from the need for conceptual and operational clarity on these two terms, the reality of token participation and siloed working environments remain barriers to achieving true multisectoral approaches in health and other areas. Relatedly, I wish to bring to the discussion one insight from our case study of tuberculosis program implementation.6 In this research, we identified facilitating and hindering factors to the successful implementation of the tuberculosis prevention and control program in cities and municipalities, and we posited that these factors were rooted in a common source of governance for health. We further extended the argument by stating that focusing on the local chief executive as the responsible entity for good governance is a myopic view of the issue as it only covers the levels that can be labelled as “broader governance environment” and “public policies.”7 The more fine-grained institutional or sectoral governance is within the ambit of the local health officer, while what we propose to refer to as “program-level” governance is the realm of the program coordinator. The scope and specificity of governance as exercised across these levels, and consequent access to precise information, differ, which highlights the shared responsibility of these three principal actors at the local level in so far as exercise of good governance is concerned. Good governance in health has been an aspirational goal for many decades, and was identified as an important constituent in our quest for better health and sustainable development. The recommendations outlined by Bernal-Sundiang et al.1 provide a starting point on how we can gradually improve the health sector to come closer to this ambition. However, embedding good governance in institutions and society at large will be critical in sustaining such gains moving forward.
ABSTRACT
The paper highlights the three key words:city, health and development.On the one hand, it is necessary to understand the city with systematic thinking, to focus on the health gap and health equity of different populations in the same city, and the continuous spectrum of health indicators or disease distribution in the same population.On the other hand, it is suggested to establish a "participatory governance" model in Healthy City development-government for health, to further promote the development of healthy cities.Finally, it briefly introduces the report of "Healthy City 2.0-Towards a Planet City" presented by Professor Hancock at the 23rd International Conference on Health Promotion of IUHPE, 2019 in New Zealand.
ABSTRACT
The paper highlights the three key words:city, health and development.On the one hand, it is necessary to understand the city with systematic thinking, to focus on the health gap and health equity of different populations in the same city, and the continuous spectrum of health indicators or disease distribution in the same population.On the other hand, it is suggested to establish a "participatory governance" model in Healthy City development-government for health, to further promote the development of healthy cities.Finally, it briefly introduces the report of "Healthy City 2.0-Towards a Planet City" presented by Professor Hancock at the 23rd International Conference on Health Promotion of IUHPE, 2019 in New Zealand.
ABSTRACT
Governance for health was defined as the activities taken by central government, local authorities, and pertinent departments, to guide the social organizations, enterprises and public, in the pursuit of health and wellbeing, in an integral approach.This article states the fundamental theories of governance for health, and its relationship to“Health China”.It emphasizes that under the leadership of the government, governance for health should establish a platform for participation and a mechanism for equal consultation and cooperation by multi-stakeholders, in order to ensure all participation and all co-sharing.In addition, the article also introduces the concept of universal health management, and illustrates the practical issues needs to be considered in implementing universal health management, from three dimensions of breadth, depth and height.“Breadth” means health management should cover all people in the country and the whole life of people.“Depth” means quality suppliers of health management should provide a list of health management services based on evidence with various packages.“Height” means in order to achieve the effectiveness of health management services, the budget should be secured and shared among the government, the enterprises and the individuals, with agreed percentage.
ABSTRACT
'Health in All Policies' is a new strategy for governance for health in 21st century. The evolution of health promotion has affected the creation of the strategy through the efforts to tackle health inequalities by addressing social determinants of health. More concern about health inequalities, involving wider policy areas, and higher level of institutionalization distinguish the strategy from the old intersectoral collaboration such as intersectoral action for health and healthy public policy. Making intersectoral collaboration the mainstream of policy making is important to address integrated policy agendas such as 'Health in All Policies' and 'Sustainable Development Goals.' Political leadership and interpersonal skills are also required to strengthen the capacity of public health sector for implementing 'Health in All Policies' in local, national, and international circumstances.