Tuesday, September 20, 2011

[EQ] Governance for health in the 21st century

Governance for health in the 21st century:
a study conducted for the WHO Regional Office for Europe

WHO regional Office for Europe – August 2011

Available online at: http://bit.ly/r25XXA

“………Mind-sets on how we view and address health and its determinants have shifted. Two challenges go hand in hand: (1) the governance of the health system and health systems strengthening, which are what we refer to as ‘health governance’; and (2) the joint action of health and non-health sectors, of the public and private sectors and of citizens for a common interest in what we call ‘governance for health’. The latter is the subject of this study.


Living in a ‘knowledge society’ means that power and authority are no longer concentrated in government. Informed citizens, conscientious businesses, independent agencies and expert bodies increasingly have a role to play. Nevertheless, governments and health ministries continue to be important in managing governance for health, setting norms, providing evidence and ‘making the healthier choice the easier choice’.


We define governance for health and well-being as ‘the attempts of governments and other actors to steer communities, whole countries or even groups of countries in the pursuit of health as integral to well-being through both whole-of-government and whole-of-society approaches’. The entire society must be understood as being responsible for its health……….”  Zsuzsanna Jakab, WHO Regional Director for Europe


Executive summary

1. 21st century governance for health and well-being

1.1 Focus of the study

1.2 Contextual drivers

1.2.1 Global interdependence: the context for governing health has changed

1.2.2 Complexity: Our understanding of health has changed and expanded

1.2.3 Co-production: The new role of citizens and civil society

2. Governance

2.1 Three key governance dynamics

2.1.1 Diffusion of governance

2.1.2 Expansion of monitory democracy

2.1.3 ‘Shared value’

2.2 The changing nature of policy-making

3. Governance for health and well-being

4. Good governance for health and well-being

4.1 What is good governance?

4.2 Role of guiding value systems

4.3 The relationship between values and evidence

5. Smart governance for health and well-being

5.1 Introduction to smart governance

5.2 Five types of smart governance for health and well-being

5.2.1 Governing through collaboration

5.2.2 Governing through citizen engagement

5.2.3 Governing by a mix of regulation and persuasion

5.2.4 Governing through independent agencies and expert bodies

5.2.5 Governing by adaptive policies, resilient structures and foresight

6. New governance for health

6.1 New role for the health sector

6.2 Political engagement and leadership

6.3 Conclusions and recommendations to the new European policy for health, Health 2020

EUR/RC61/Inf.Doc./6 - Glossary – Bibliography


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