Governance is too complex for a simple definition. Broadly, governance encompasses ‘the collective action and mechanism of a society to achieve common and agreed goals’. Governance therefore should, on a daily basis, embrace and have positive effect on every aspect of societal activities, from politics to economy and from health to social activities. Health governance is the component of governance focusing on the ‘actions and measures adopted by a society for the promotion and protection of the health of its population’. Global health governance is a term that has evolved over time and is still evolving. Regarding the definition and practice of governance and health governance, African countries have generally adopted, with minimal adaptation, the global definitions and dictates of bilateral partners and international agencies. African countries need to devise a mechanism and a framework for quantifying and acknowledging domestic input.