Health System Governance Evaluation: A Scoping Review
Abstract
Background: Governance is one of the critical functions of the health system. Good governance of the health system leads to better performance and outcomes. Evaluation is the first step to improving health system governance. Therefore, this research aimed to identify evaluation tools for health system governance.
Methods: In the current scoping review, we searched all documents related to health system governance evaluation indexed in Medline, EMBASE, ProQuest, Scopus, Cochrane Library, Science Direct databases, and Google Scholar search engines to 2022, extracted, and assessed. Finally, documents were selected and analyzed by thematic analysis.
Results: Thirty tools were found to evaluate health system governance. Among the proposed tools, 11 specific tools have been designed just for health system governance evaluation, while others have governance as a component of health system evaluation. Health system governance’s significant components are health policy-making, strategic planning, organizing, stewardship, and control. Indicators such as accountability, participation, transparency, equity, efficiency, accountability, corruption control, effectiveness, ethic, the rule of law, and sustainability could be used to evaluate the health system governance.
Conclusion: Different tools have been used to evaluate governance worldwide, and each governance evaluation tool has different components suitable for governance evaluation. However, these tools cannot fully evaluate governance and have shortcomings. A comprehensive evaluation of governance and sharing lessons denrael will affect the health system's capacity and ability to provide quality, safe and effective health services. It will lead to the stability of the health system.
1. World Health Organization Regional Office for Europe(2018). European health report 2018: more than numbers – evidence for all. World Health Organization. Regional Office for Europe.112-8.
2. Apostolopoulos Y, Sönmez S(2007). Demographic and epidemiological perspectives of human movement. Population Mobility and Infectious Disease. Springer. p. 1-16.
3. Hamra R, Siddiqi S, Carmel E, Ammar W(2020). Assessing the governance of the health policy-making process using a new governance tool: the case of Lebanon. Health Research Policy and Systems, 18(1):1-16.
4. World Health Assembly (2000). The World Health Report 2000: health systems: improving performance. World Health Organization.81-9.
5. World Health Organization (2007). Everybody's business -strengthening health systems to improve health outcomes : WHO's framework for action. World Health Organization.24-8.
6. World Health Organization (2009). Measuring transparency in the public pharmaceutical sector: assessment instrument. World Health Organization.Geneva:.10-7.
7. Mikkelsen-Lopez I, Wyss K, de Savigny D(2011). An approach to addressing governance from a health system framework perspective. BMC Int Health Hum Rights, 11:13.
8. Biglar M, Bastani P, Vatan khah S(2013). The Challenges Of Stewardship In Medical Education System: A Qualitative Approach. Payavard Salamat, 7(4):299-311.
9. Shahri S, Tabibi SJ, Nasiripour AA, Ghaffari F(2017). Effect Functions on Goals of Health System in Iran. Payavard Salamat, 11(3):247-58.
10. Dyer O(2006). New report on corruption in health. Bulletin of the World Health Organization, 84:84-7.
11. Nafees AA, Nayani P (2011). Stewardship in Health Policy and its relevance to Pakistan. J Pak Med Assoc, 61(8):795-800.
12. United Nations Development Programme(1997).Governance for sustainable human development A UNDP policy document.United Nations New York.Development Programme.22-6.
13. Aart Kraay, Pablo Zoido-Lobaton, Daniel Kaufmann(1999). Governance Matters .Policy Research Working Paper, Series 2196. The World Bank.
14. Health Systems 20/20. 2012. The Health System Assessment Approach: A How-To Manual. Version 2.0.WashingtonDC .USAID .10-5.
15. Siddiqi S, Masud TI, Nishtar S, Peters DH, Sabri B, Bile KM, et al.(2009). Framework for assessing governance of the health system in developing countries: gateway to good governance. Health Policy, 90(1):13-25.
16. Levac D, Colquhoun H, O'Brien KK(2010). Scoping studies: advancing the methodology. Implement Sci, 5(1):1-9.
17. Wagman P, Håkansson C, Jonsson H(2015). Occupational balance: A scoping review of current research and identified knowledge gaps. Journal of Occupational Science, 22(2):160-9.
18. Arksey H, O'Malley L(2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1):19-32.
19. Mitton C, Adair CE, McKenzie E, Patten SB, Perry BW(2007). Knowledge transfer and exchange: review and synthesis of the literature. Milbank Q, 85(4):729-68.
20. Braun V, Clarke V(2006). Using thematic analysis in psychology. Qual Res Psychol, 3(2):77-101.
21. Abimbola S, Negin J, Jan S, Martiniuk A(2014). Towards people-centred health systems: a multi-level framework for analysing primary health care governance in low-and middle-income countries. Health Policy Plan, 29 Suppl 2(Suppl 2):ii29-39.
22. Lewis M, Pettersson Gelander G(2009). Governance in health care delivery: raising performance.World Bank Policy Research Working Paper. World Bank:4-9.
23. Mutale W, Mwanamwenge MT, Balabanova D, Spicer N, Ayles H(2013). Measuring governance at health facility level: developing and validation of simple governance tool in Zambia. BMC Int Health Hum Rights, 13:49.
24. Kaplan AD, Dominis S, Palen JG, Quain EE(2013). Human resource governance: what does governance mean for the health workforce in low-and middle-income countries? Hum Resour Health, 11:6.
25. Sharma A, Prinja S, Aggarwal AK(2018). Measurement of health system performance at district level: A study protocol. J Public Health Res, 6(3):917.
26. World Health Organization(2010). Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. World Health Organization.
27. Islam M(2007). Health systems assessment approach: a how-to manual.United States Agency for International Development. Washington DC United States:168-79.
28. Baez Camargo C, Jacobs E(2011). A Framework to Assess Governance of Health Systems in Low Income Countries. Basel Institute on Governance Working Paper Series. Basel, Switzerland.
29. Kirigia JM, Kirigia DG(2011). The essence of governance in health development. Int Arch Med, 4:11.
30. World Health Organization(2008).Health information systems: Toolkit on monitoring health systems strengthening.Geneva: WHO.
31. Mosadeghrad AM(2020). An integrated health policy making and analysis model. Tehran Univ Med J, 77(12):791-791.
32. Mosadeghrad AM(2019). Health strengthening plan, a supplement to Iran health transformation plan. Tehran Univ Med J, 77(8):537-8.
33. Mosadeghrad AM, Rahimi-Tabar P(2019). Health system governance in Iran: A comparative study. Razi J Med Sci, 26(9):10-28.
34. Mosadeghrad A(2015). Essentials of healthcare organization and management. Dibagran Tehran.
35. Murray CJ, Frenk J(2002). A framework for assessing the performance of health systems. Bull World Health Organ, 78(6):717-31.
36. World Health Organization(2007). Good governance for medicines Assessment instrument. World Health Organization Geneva,Switzerland..
37. Tbilisi G(2008). Stewardship/governance of health systems in the WHO European Region. Proceedings of the Regional Committee for Europe fifty-eighty session. World Health Organization. Denmark. p. 15-8.
38. Brinkerhoff DW, Bossert TJ. (2008). Health Governance: Concepts,Experience, and Programming Options. Health Systems 20/20 project.United States Agency for International Development.4-7.
39. Savedoff WD(2013). Governance in the health sector: a strategy for measuring determinants and performance .Policy Research Working Paper. World Bank. Portland. p. 56-55.
40. Omaswa F, Boufford JI(2010). Strong ministries for strong health systems: An overview of the study report: Supporting Ministerial Health Leadership: A Strategy for Health Systems Strengthening. New York: The African Center for Global Health and Social Transformation (ACHEST) and The New York Academy of Medicine (NYAM). The African Center for Global Health and Social Transformation (ACHEST) and The New York Academy of Medicine (NYAM). New York. p. 34-9.
41. Veillard JHM, Brown AD, Barış E, Permanand G, Klazinga NS(2011). Health system stewardship of National Health Ministries in the WHO European region: concepts, functions and assessment framework. Health Policy, 103(2-3):191-9.
42. Van Olmen J, Marchal B, Van Damme W, Kegels G, Hill PS(2012). Health systems frameworks in their political context: framing divergent agendas. BMC Public Health, 12:774.
43. UN Refugee Agency(2012). States on the implementation of good governance principles in health systems. Council of Europe: Committee of Ministers. Switzerland. p. 121-5.
44. Wendt D, Bouchet Y-SL, Nanda L, Noriega S, Rakhmanova N, Searle S(2013). Health system rapid diagnostic tool. FHI 360. Durham. p. 41-8.
45. Shukla M, Colindres H, Orton M(2013). How to govern the health sector and its institutions effectively. In: 1, editor. United States Agency International Development Programme. Arlington. p. 3-9.
46. Barbazza E, Tello JE(2014). A review of health governance: definitions, dimensions and tools to govern. Health Policy, 116(1):1-11.
47. Greer S, Wismar M, Figueras J(2015). EBOOK: Strengthening Health System Governance: Better policies, stronger performance. Open University Press. McGraw-Hill Education (UK). p. 27-39.
2. Apostolopoulos Y, Sönmez S(2007). Demographic and epidemiological perspectives of human movement. Population Mobility and Infectious Disease. Springer. p. 1-16.
3. Hamra R, Siddiqi S, Carmel E, Ammar W(2020). Assessing the governance of the health policy-making process using a new governance tool: the case of Lebanon. Health Research Policy and Systems, 18(1):1-16.
4. World Health Assembly (2000). The World Health Report 2000: health systems: improving performance. World Health Organization.81-9.
5. World Health Organization (2007). Everybody's business -strengthening health systems to improve health outcomes : WHO's framework for action. World Health Organization.24-8.
6. World Health Organization (2009). Measuring transparency in the public pharmaceutical sector: assessment instrument. World Health Organization.Geneva:.10-7.
7. Mikkelsen-Lopez I, Wyss K, de Savigny D(2011). An approach to addressing governance from a health system framework perspective. BMC Int Health Hum Rights, 11:13.
8. Biglar M, Bastani P, Vatan khah S(2013). The Challenges Of Stewardship In Medical Education System: A Qualitative Approach. Payavard Salamat, 7(4):299-311.
9. Shahri S, Tabibi SJ, Nasiripour AA, Ghaffari F(2017). Effect Functions on Goals of Health System in Iran. Payavard Salamat, 11(3):247-58.
10. Dyer O(2006). New report on corruption in health. Bulletin of the World Health Organization, 84:84-7.
11. Nafees AA, Nayani P (2011). Stewardship in Health Policy and its relevance to Pakistan. J Pak Med Assoc, 61(8):795-800.
12. United Nations Development Programme(1997).Governance for sustainable human development A UNDP policy document.United Nations New York.Development Programme.22-6.
13. Aart Kraay, Pablo Zoido-Lobaton, Daniel Kaufmann(1999). Governance Matters .Policy Research Working Paper, Series 2196. The World Bank.
14. Health Systems 20/20. 2012. The Health System Assessment Approach: A How-To Manual. Version 2.0.WashingtonDC .USAID .10-5.
15. Siddiqi S, Masud TI, Nishtar S, Peters DH, Sabri B, Bile KM, et al.(2009). Framework for assessing governance of the health system in developing countries: gateway to good governance. Health Policy, 90(1):13-25.
16. Levac D, Colquhoun H, O'Brien KK(2010). Scoping studies: advancing the methodology. Implement Sci, 5(1):1-9.
17. Wagman P, Håkansson C, Jonsson H(2015). Occupational balance: A scoping review of current research and identified knowledge gaps. Journal of Occupational Science, 22(2):160-9.
18. Arksey H, O'Malley L(2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1):19-32.
19. Mitton C, Adair CE, McKenzie E, Patten SB, Perry BW(2007). Knowledge transfer and exchange: review and synthesis of the literature. Milbank Q, 85(4):729-68.
20. Braun V, Clarke V(2006). Using thematic analysis in psychology. Qual Res Psychol, 3(2):77-101.
21. Abimbola S, Negin J, Jan S, Martiniuk A(2014). Towards people-centred health systems: a multi-level framework for analysing primary health care governance in low-and middle-income countries. Health Policy Plan, 29 Suppl 2(Suppl 2):ii29-39.
22. Lewis M, Pettersson Gelander G(2009). Governance in health care delivery: raising performance.World Bank Policy Research Working Paper. World Bank:4-9.
23. Mutale W, Mwanamwenge MT, Balabanova D, Spicer N, Ayles H(2013). Measuring governance at health facility level: developing and validation of simple governance tool in Zambia. BMC Int Health Hum Rights, 13:49.
24. Kaplan AD, Dominis S, Palen JG, Quain EE(2013). Human resource governance: what does governance mean for the health workforce in low-and middle-income countries? Hum Resour Health, 11:6.
25. Sharma A, Prinja S, Aggarwal AK(2018). Measurement of health system performance at district level: A study protocol. J Public Health Res, 6(3):917.
26. World Health Organization(2010). Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. World Health Organization.
27. Islam M(2007). Health systems assessment approach: a how-to manual.United States Agency for International Development. Washington DC United States:168-79.
28. Baez Camargo C, Jacobs E(2011). A Framework to Assess Governance of Health Systems in Low Income Countries. Basel Institute on Governance Working Paper Series. Basel, Switzerland.
29. Kirigia JM, Kirigia DG(2011). The essence of governance in health development. Int Arch Med, 4:11.
30. World Health Organization(2008).Health information systems: Toolkit on monitoring health systems strengthening.Geneva: WHO.
31. Mosadeghrad AM(2020). An integrated health policy making and analysis model. Tehran Univ Med J, 77(12):791-791.
32. Mosadeghrad AM(2019). Health strengthening plan, a supplement to Iran health transformation plan. Tehran Univ Med J, 77(8):537-8.
33. Mosadeghrad AM, Rahimi-Tabar P(2019). Health system governance in Iran: A comparative study. Razi J Med Sci, 26(9):10-28.
34. Mosadeghrad A(2015). Essentials of healthcare organization and management. Dibagran Tehran.
35. Murray CJ, Frenk J(2002). A framework for assessing the performance of health systems. Bull World Health Organ, 78(6):717-31.
36. World Health Organization(2007). Good governance for medicines Assessment instrument. World Health Organization Geneva,Switzerland..
37. Tbilisi G(2008). Stewardship/governance of health systems in the WHO European Region. Proceedings of the Regional Committee for Europe fifty-eighty session. World Health Organization. Denmark. p. 15-8.
38. Brinkerhoff DW, Bossert TJ. (2008). Health Governance: Concepts,Experience, and Programming Options. Health Systems 20/20 project.United States Agency for International Development.4-7.
39. Savedoff WD(2013). Governance in the health sector: a strategy for measuring determinants and performance .Policy Research Working Paper. World Bank. Portland. p. 56-55.
40. Omaswa F, Boufford JI(2010). Strong ministries for strong health systems: An overview of the study report: Supporting Ministerial Health Leadership: A Strategy for Health Systems Strengthening. New York: The African Center for Global Health and Social Transformation (ACHEST) and The New York Academy of Medicine (NYAM). The African Center for Global Health and Social Transformation (ACHEST) and The New York Academy of Medicine (NYAM). New York. p. 34-9.
41. Veillard JHM, Brown AD, Barış E, Permanand G, Klazinga NS(2011). Health system stewardship of National Health Ministries in the WHO European region: concepts, functions and assessment framework. Health Policy, 103(2-3):191-9.
42. Van Olmen J, Marchal B, Van Damme W, Kegels G, Hill PS(2012). Health systems frameworks in their political context: framing divergent agendas. BMC Public Health, 12:774.
43. UN Refugee Agency(2012). States on the implementation of good governance principles in health systems. Council of Europe: Committee of Ministers. Switzerland. p. 121-5.
44. Wendt D, Bouchet Y-SL, Nanda L, Noriega S, Rakhmanova N, Searle S(2013). Health system rapid diagnostic tool. FHI 360. Durham. p. 41-8.
45. Shukla M, Colindres H, Orton M(2013). How to govern the health sector and its institutions effectively. In: 1, editor. United States Agency International Development Programme. Arlington. p. 3-9.
46. Barbazza E, Tello JE(2014). A review of health governance: definitions, dimensions and tools to govern. Health Policy, 116(1):1-11.
47. Greer S, Wismar M, Figueras J(2015). EBOOK: Strengthening Health System Governance: Better policies, stronger performance. Open University Press. McGraw-Hill Education (UK). p. 27-39.
| Files | ||
| Issue | Vol 52 No 2 (2023) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i2.11880 | |
| Keywords | ||
| Governance Evaluation Scoping review Health system | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Khosravi MF, Mosadeghrad AM, Arab M. Health System Governance Evaluation: A Scoping Review. Iran J Public Health. 2023;52(2):265-277.
