RGH Video Blog – 10 Functions for Any Governance Program in a Health System
Hello, welcome to Realizing Global Health. My name is Dr. Elvira Beracochea. I am the president, CEO and founder of Realizing Global Health. We are a global health consulting company where we work with clients to help them develop self-reliant, sustainable health systems that deliver quality healthcare to everyone everywhere every day. Today, the topic of discussion is the fifth key to sustainable global health programs.
In past installments, we talked about focusing what we do in the health system. We talked about understanding how health programs work and how they make the health system work. We talked about services in facilities. We also talked about health providers.
Today we are going to talk about the important function of governance. Governance is at the head of the health system and it needs to work clearly. Unless there is ownership in the country, and they can take leadership in how all of the activities that develop the health system work, it is very difficult to sustain the achievements we have made in global health. That’s why I really want you to think: “What are the governance functions I need in my country to make sure that we are doing work that is going to be lasting, effective, and really going contribute to the development of the health system?” We need to do this to insure that we are providing quality healthcare to everyone everywhere every day.
There are 10 functions that are important for any governance program in the health system.
Policy & Planning: ‘Policy’ says what has to be done and how. ‘Planning’ makes sure that it happens. Every year we make annual plans in addition to the 5 or 10 year health plans that says how things are going to happen to make sure we enforce and fulfill our policies.
Monitor & Evaluate: We need to monitor how health activities are being implemented on a regular basis—preferably in real time. There are many tools to do that. Then we need to evaluate. Monitoring tells us if we are doing things the way we said we were going to do them. Are we getting the results that we want? With evaluation, we look to see if the objectives we set were the ones that were accomplished. Are those objectives the ones we wanted to achieve? Sometimes objectives and priorities change. It is not that we are doing the wrong work, it is that we are not addressing other priorities and objectives, so this is why we need to evaluate our objectives to see if they are still important.
Financing: The Ministry of Health and Ministry of Finance need to work together, to coordinate with donors and other organizations that contribute to the national health budget.
Health Surveillance System: If there is an outbreak of Ebola, for example, you will want to know. You need to have weekly morbidity and mortality reports that tell you how well the health system is working. Everybody needs to have access to this information.
Regulation & Accreditation: How does the health system regulate whether this place can really provide health care or not? They have to be accredited. You need to make sure there are regulations on food hygiene, sanitation, etc. All these things need to be in place—and that is what the governance function does.
Partnerships & Donor Coordination: We need to make sure that the donors are coordinated. You need to have the structures that do that. You need to make sure that you are managing the partnerships- not only with donors but also with other organizations in the private sector, business sector and NGOs.
These 10 functions are very important and we have to make sure are they really working. If you have all of the above mentioned functions then you can have a great global health governance program that is going to keep improving the health system that will really delivery quality health care to everyone everywhere every day.
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