Health system governance


    Effective Health System Governance for Universal Health Coverage UHC

    Leadership and governance involves ensuring strategic policy frameworks exist and are combined with effective oversight, coalition-building, regulation, attention to system-design and accountability. Three main categories of stakeholders who interact with each other determine the health system and its governance:  

    • the State (government organizations and agencies at central and sub-national level);
    • the health service providers (different public and private for and not for profit clinical, para-medical and non-clinical health services providers; unions and other professional associations; networks of care or of services);
    • the citizen (population representatives, patients’ associations, CSOs/NGOs, citizens associations protecting the poor, etc.) who become service users when they interact with health service providers.

    In the framework of the Sustainable Development Goals agenda, WHO works to support countries to exercise effective health systems governance, focused on strengthening  the capacity of governments to develop and implement strategies towards achieving UHC by 2030. 


    In practice

    WHO’s work in Health System Governance aims at empowering actors and increasing accountability, transparency and responsiveness of health systems through actions focused on:  

    • Support development of  comprehensive and costed national health policies and strategies that enable effective implementation of primary health care towards universal health coverage, including health security;
    • Strengthen and reform health institutions, laws and regulations, including legal frameworks for universal health coverage that contribute to access, quality and financial risk protection;
    • Establish mechanisms to support whole-of-society approaches, promote the empowerment of people and communities in oversight functions and the representation of citizens in health decision-making processes and gender equality;
    • Work with parliamentarians to support laws and budgets for universal health coverage;
    • Institutionalize whole-of-government and whole-of-society approaches, together with the Health in All Policies approach, through multisectoral, multistakeholder and inclusive collaboration with all national and international stakeholders that is accountable and transparent, with specific efforts to harness the private sector in order to help to achieve universal health coverage;
    • Develop norms and standards for monitoring national universal health coverage policies and strategies, strengthen national monitoring of policy implementation and ensure the establishment of legal frameworks that promote, enforce and monitor equity, gender and human rights;
    • Support the harmonization and alignment of costed and financed national action plans for health security with national health strategies.



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