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Governance in the health sector: a strategy for measuring determinants and performance

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  • Savedoff, William D.

Abstract

Many different strategies have been proposed to improve the delivery of health care services, from capacity building to establishing new payment mechanisms. Recent attention has also asked whether improvements in the way health care services are governed could make a difference. These approaches ask which factors -- such as rules and institutions -- influence the behavior of the system in ways that are associated with better performance and outcomes. This paper reviews the concept of governance as it is used in the literature on private firms, public administration, international development and health. It distinguishes between indicators that measure governance determinants from those that measure governance performance in order to propose a framework that is analytically coherent and empirically useful. The framework shows how these indicators can be used to test hypotheses about which governance forms are more useful for improving health system performance. The paper concludes by proposing specific measures of governance determinants and performance and describes the instruments available to collect and interpret them.

Suggested Citation

  • Savedoff, William D., 2011. "Governance in the health sector: a strategy for measuring determinants and performance," Policy Research Working Paper Series 5655, The World Bank.
  • Handle: RePEc:wbk:wbrwps:5655
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    Citations

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    Cited by:

    1. Ciccone, Dana Karen & Vian, Taryn & Maurer, Lydia & Bradley, Elizabeth H., 2014. "Linking governance mechanisms to health outcomes: A review of the literature in low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 117(C), pages 86-95.
    2. Changwoo Shon & Myoungsoon You, 2020. "Evaluation of Health Policy Governance in the Introduction of the New DRG-Based Hospital Payment System from Interviews with Policy Elites in South Korea," IJERPH, MDPI, vol. 17(11), pages 1-18, May.
    3. Chiara Bertoncello & Alessandra Buja & Andrea Silenzi & Maria Specchia & Giuseppe Franchino & Agnese Lazzari & Vincenzo Baldo & Walter Ricciardi & Gianfranco Damiani, 2015. "Good governance competencies in public health to train public health physicians," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(6), pages 737-749, September.
    4. Raj Panda & Pradeep Guin & Kumar Gaurav, 2020. "Governance in Public Purchasing of Tertiary-Level Health Care: Lessons From Madhya Pradesh, India," SAGE Open, , vol. 10(3), pages 21582440209, July.
    5. Jackline Sitienei & Lenore Manderson & Mabel Nangami, 2021. "Community participation in the collaborative governance of primary health care facilities, Uasin Gishu County, Kenya," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-19, March.

    More about this item

    Keywords

    Health Monitoring&Evaluation; Governance Indicators; National Governance; Health Systems Development&Reform; Health Economics&Finance;
    All these keywords.

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