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Governance in health care delivery : raising performance

  • Lewis, Maureen
  • Pettersson, Gunilla

The impacts of health care investments in developing and transition countries are typically measured by inputs and general health outcomes. Missing from the health agenda are measures of performance that reflect whether health systems are meeting their objectives; public resources are being used appropriately; and the priorities of governments are being implemented. This paper suggests that good governance is central to raising performance in health care delivery. Crucial to high performance are standards, information, incentives and accountability. This paper provides a definition of good governance in health and a framework for thinking about governance issues as a way of improving performance in the health sector. Performance indicators that offer the potential for tracking relative health performance are proposed, and provide the context for the discussion of good governance in health service delivery in the areas of budget and resource management, individual provider performance, health facility performance, informal payments, and corruption perceptions. What we do and do not know about effective solutions to advance good governance and performance in health is presented for each area, drawing on existing research and documented experiences.

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Paper provided by The World Bank in its series Policy Research Working Paper Series with number 5074.

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Date of creation: 01 Oct 2009
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Handle: RePEc:wbk:wbrwps:5074
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  1. Kathleen J. Mullen & Richard G. Frank & Meredith B. Rosenthal, 2009. "Can You Get What You Pay For? Pay-For-Performance and the Quality of Healthcare Providers," Working Papers 680, RAND Corporation Publications Department.
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  11. Gerard M. La Forgia & Bernard F. Couttolenc, 2008. "Hospital Performance in Brazil : The Search For Excellence," World Bank Other Operational Studies 10284, The World Bank.
  12. Salman Zaidi & Asad Alam & Pradeep Mitra & Ramya Sundaram, 2009. "Satisfaction with Life and Service Delivery in Eastern Europe and the Former Soviet Union : Some Insights from the 2006 Life in Transition Survey," World Bank Publications, The World Bank, number 5955, December.
  13. Olken, Benjamin A., 2009. "Corruption perceptions vs. corruption reality," Journal of Public Economics, Elsevier, vol. 93(7-8), pages 950-964, August.
  14. Reinikka, Ritva & Svensson, Jakob, 2004. "Working for God?," CEPR Discussion Papers 4214, C.E.P.R. Discussion Papers.
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  16. Leonard, Kenneth L. & Masatu, Melkiory C., 2008. "Professionalism, Latent Professionalism and Organizational Demands for Health Care Quality in a Developing Country," Working Papers 42883, University of Maryland, Department of Agricultural and Resource Economics.
  17. Gerard M. La Forgia & Bernard F. Couttolenc, 2008. "Hospital Performance in Brazil : The Search for Excellence," World Bank Publications, The World Bank, number 6516, December.
  18. Rogers, F. Halsey & Vegas, Emiliana, 2009. "No more cutting class ? reducing teacher absence and providing incentives for performance," Policy Research Working Paper Series 4847, The World Bank.
  19. Lewis, Maureen A. & La Forgia, Gerald M. & Sulvetta, Margaret B., 1996. "Measuring public hospital costs: Empirical evidence from the Dominican Republic," Social Science & Medicine, Elsevier, vol. 43(2), pages 221-234, July.
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  25. repec:cup:cbooks:9780521790956 is not listed on IDEAS
  26. Belli, Paolo & Gotsadze, George & Shahriari, Helen, 2004. "Out-of-pocket and informal payments in health sector: evidence from Georgia," Health Policy, Elsevier, vol. 70(1), pages 109-123, October.
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  28. Dasgupta, Basab & Narayan, Ambar & Skoufias, Emmanuel, 2009. "Measuring the quality of education and health services : the use of perception data from Indonesia," Policy Research Working Paper Series 5033, The World Bank.
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