Governance in Health Care Delivery : Raising Performance

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.

Bibliographic Details

Main Authors:	Lewis, Maureen, Pettersson, Gunilla
Language:	English
Published:	2009-10-01
Subjects:	ABSENTEEISM, ACCOUNTABILITY, ACCOUNTABILITY FOR PERFORMANCE, ACCOUNTABILITY MECHANISMS, ACCOUNTING, AGGREGATE EXPENDITURE, AGGREGATE EXPENDITURES, ANNUAL BUDGET, ANNUAL BUDGET PROCESS, AUDIT FINDINGS, AUDITORS, AUTHORIZED BUDGET, AUXILIARY NURSES, BANDAGES, BASIC SERVICES, BENEFICIARIES, BUDGET ACCOUNTS, BUDGET ALLOCATION, BUDGET ALLOCATIONS, BUDGET COMPREHENSIVENESS, BUDGET CREDIBILITY, BUDGET CYCLE, BUDGET EXECUTION, BUDGET MANAGEMENT, BUDGET PROCESS, BUDGET RECORDS, BUDGET RULES, CAPITAL EXPENDITURES, CASH BALANCES, CENTRAL GOVERNMENT, CERTIFICATION, CLINICS, COMMUNITY PARTICIPATION, CORRUPTION DATA, DATA COLLECTION, DATA ENTRY, DATA ON PERFORMANCE, DEATHS, DEBT, DELIVERY OF HEALTH SERVICES, DOCTORS, EDUCATION PROGRAMS, EFFECTIVENESS OF SERVICE DELIVERY, EFFICIENCY OF PUBLIC SPENDING, EMPLOYMENT, ESSENTIAL DRUGS, EXPENDITURE AREAS, EXPENDITURE CATEGORIES, EXPENDITURE CONTROLS, EXPENDITURE PROGRAM, EXPENDITURE TRACKING SURVEYS, EXTERNAL ACCOUNTABILITY, EXTERNAL AUDIT, EXTERNAL AUDITS, FINANCE MANAGEMENT, FINANCE MINISTRIES, FINANCIAL ACCOUNTABILITY, FINANCIAL INFORMATION, FINANCIAL MANAGEMENT, FINANCIAL MANAGEMENT SYSTEMS, FINANCIAL REPORTS, FINANCIAL RESOURCES, FINANCING ARRANGEMENTS, GOVERNMENT BUDGETS, GOVERNMENT POLICIES, HEALTH CARE, HEALTH CARE DELIVERY, HEALTH CARE FACILITIES, HEALTH CARE PROFESSIONALS, HEALTH CARE PROVIDERS, HEALTH CARE PROVISION, HEALTH CARE SERVICE DELIVERY, HEALTH CARE SYSTEM, HEALTH CARE SYSTEMS, HEALTH CLINIC, HEALTH CLINICS, HEALTH CONSEQUENCES, HEALTH DEPARTMENTS, HEALTH EXPENDITURE, HEALTH EXPENDITURES, HEALTH FACILITIES, HEALTH INSURANCE, HEALTH INVESTMENTS, HEALTH MINISTRIES, HEALTH OUTCOMES, HEALTH POLICIES, HEALTH POLICY, HEALTH PROJECTS, HEALTH PROVIDERS, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE DELIVERY, HEALTH SERVICE PROVIDERS, HEALTH SERVICE PROVISION, HEALTH SERVICES, HEALTH SPENDING, HEALTH STATUS, HEALTH SYSTEM, HEALTH SYSTEMS, HEALTH UNIT, HEALTH WORKFORCE, HIV/AIDS, HOSPITAL BEDS, HOSPITAL MANAGEMENT, HOSPITAL PATIENTS, HOSPITAL PERFORMANCE, HOSPITALS, HUMAN DEVELOPMENT, HUMAN RESOURCE MANAGEMENT, HUMAN RESOURCES, ILLNESS, IMMUNIZATION, INCOME, INFANT MORTALITY, INSTITUTIONALIZATION, INSURANCE, INTEGRATION, INTENDED BENEFICIARIES, INTERGOVERNMENTAL FISCAL RELATIONS, INTERMEDIARIES, INTERNAL AUDIT, INTERNAL CONTROL, INTERNAL CONTROLS, LAWS, LIFE EXPECTANCY, LINES OF ACCOUNTABILITY, LIVING CONDITIONS, MANAGEMENT CONTROL, MANAGEMENT CONTROLS, MEASURABLE OUTPUTS, MEDICAL CARE, MEDICAL EDUCATION, MEDICAL EQUIPMENT, MEDICAL SUPPLIES, MEDICINES, MIGRATION, MINISTRY OF FINANCE, MISMANAGEMENT, MORTALITY, NURSES, NURSING, OUTCOME INDICATORS, PATIENT, PATIENT SATISFACTION, PATIENTS, PAYMENT SYSTEM, PERFORMANCE DATA, PERFORMANCE INDICATORS, PERFORMANCE INFORMATION, PERFORMANCE ISSUES, PERFORMANCE MEASURES, PERFORMANCE MONITORING, PHARMACISTS, PHARMACY, PHYSICIAN, PHYSICIANS, POLITICIANS, PRIVATE MARKET, PRIVATE PHARMACIES, PRIVATE SECTOR, PROBABILITY, PROCUREMENT PROCESS, PROGRAM MANAGERS, PROGRAM OBJECTIVES, PROGRAMS, PROVIDER PAYMENT, PROVISION OF HEALTH SERVICES, PUBLIC EXPENDITURE, PUBLIC EXPENDITURE TRACKING, PUBLIC EXPENDITURES, PUBLIC FINANCE, PUBLIC FINANCIAL MANAGEMENT, PUBLIC FUNDS, PUBLIC HEALTH, PUBLIC HEALTH CARE, PUBLIC HEALTH CARE SERVICES, PUBLIC HEALTH SYSTEMS, PUBLIC HEALTH WORKERS, PUBLIC HOSPITALS, PUBLIC INVESTMENTS, PUBLIC OFFICIALS, PUBLIC PROCUREMENT, PUBLIC PROVISION, PUBLIC RESOURCES, PUBLIC SECTOR, PUBLIC SECTOR MANAGEMENT, PUBLIC SERVICE, QUALITY CONTROL, QUALITY OF HEALTH, QUALITY OF HEALTH CARE, QUANTITATIVE SERVICE DELIVERY, REGIONAL ADMINISTRATION, RESOURCE ALLOCATION, RESOURCE FLOWS, SECTOR POLICY, SERVICE QUALITY, TRANSPARENCY, UNINTENDED CONSEQUENCES, USE PERFORMANCE INFORMATION, WASTE, WORK ENVIRONMENT, WORKERS,
Online Access:	http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20091013151915 https://hdl.handle.net/10986/4266
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