ABSTRACT

Governing Health Systems: For Nations and Communities Around the World examines the complex relationships between governance and performance in community and national health systems. Each chapter provides an in-depth case study, using both qualitative and quantitative methods, on health systems in many countries, including Uganda, Ghana, India, Zambia, Japan, Nigeria, Indonesia, Brazil, Palestine, and South Korea. The chapters were written by former Takemi Fellows, who were mid-career research fellows at the Harvard T.H. Chan School of Public Health, and their colleagues. This case study approach yields important findings as well as contextual insights about the challenges and accomplishments in addressing governance issues in national and community health systems around the world.

Health policymakers around the world are struggling to address the multiple challenges of governing health systems. These challenges also represent important themes for the research mission of the Takemi Program in International Health at the Harvard T.H. Chan School of Public Health. This book is based on the program’s thirtieth anniversary symposium held in October 2013 at Harvard. The studies presented in this book—deep examinations of illustrative examples of health system governance for communities and nations—contribute to our knowledge about global health and assist policymakers in dealing with the complex practical problems of health systems. In short, this book addresses central questions about governing health systems—and why governance matters.

part |2 pages

PART I

chapter 2|9 pages

Community Participation in Governance of the Health Care System: A Look at Health Unit Management Committees in Uganda

Community Participation in Governance of the Health Care System: A Look at Health Unit Management Committees in Uganda

chapter |10 pages

Challenges Facing Management Committees

chapter |3 pages

REFERENCES

chapter 3|15 pages

CHAPTER 3

Governance and Performance of Public District Hospitals in the Eastern Region of Ghana

chapter |8 pages

Governance and Hospital Performance

chapter |6 pages

Performance and Governance

chapter |4 pages

REFERENCES

chapter 4|22 pages

Managing Grassroots Health Systems in Kerala: The Roles and Capacities of Local Self-Government Institutions

Managing Grassroots Health Systems in Kerala: The Roles and Capacities of Local Self-Government Institutions

chapter |2 pages

REFERENCES

chapter 5|14 pages

Leveraging the Voice of Community Workers in Health Governance: A Two-Case Study from Zambia and Japan

Leveraging the Voice of Community Workers in Health Governance: A Two-Case Study from Zambia and Japan

chapter |2 pages

Skills

chapter |2 pages

Leadership

chapter 6|4 pages

Community Perception of Health Services in South East Nigeria: A Reflection of Health System Governance in Nigeria

Community Perception of Health Services in South East Nigeria: A Reflection of Health System Governance in Nigeria

chapter |8 pages

MATERIALS AND METHODS

part |2 pages

PART II

chapter 7|19 pages

Governing Social Health Insurance Systems for Universal Coverage: The Case of Indonesia

Governing Social Health Insurance Systems for Universal Coverage: The Case of Indonesia

chapter |3 pages

REFERENCES

chapter 8|29 pages

CHAPTER 8

Governance and Health System Performance: National and Municipal Challenges to the Brazilian Family Health Strategy

chapter |5 pages

REFERENCES

chapter 9|15 pages

Challenges in Reforming the Health System to Prevent Maternal Deaths in Low-Income Countries: A Case Study of Nigeria

Challenges in Reforming the Health System to Prevent Maternal Deaths in Low-Income Countries: A Case Study of Nigeria INTRODUCTION: THE HISTORICAL CONTEXT

chapter |10 pages

Intensified Drug Regulatory Policy

chapter |5 pages

REFERENCES

chapter 10|9 pages

CHAPTER 10

Governing the Reform of the United Nations Health Systems for Palestine Refugees: Moving Mountains

chapter |17 pages

Financing Health Reform

chapter 11|23 pages

CHAPTER 11

The Challenges of Governing the Korean National Health Insurance System and Its Implications: Financial Sustainability and Accountability

chapter 12|5 pages

CHAPTER 12

Participation of the Lay Public in Decision Making for Benefits Coverage of National Health Insurance in South Korea

chapter |3 pages

POLICY IMPLICATIONS

part |2 pages

PART III

chapter |7 pages

Reflections (i)

chapter |2 pages

Reflections (ii)

chapter |5 pages

Reflections (iii)

chapter |11 pages

APPENDIX

Short History of the Takemi Program in International Health and List of Takemi Fellows, 1984–2013 SHORT HISTORY OF THE TAKEMI PROGRAM IN INTERNATIONAL HEALTH

chapter |2 pages

ACKNOWLEDGMENTS