Practicing governance towards equity in health systems: LMIC perspectives and experience.

Lucy Gilson, Uta Lehmann, Helen Schneider
Author Information
  1. Lucy Gilson: School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. lucy.gilson@uct.ac.za. ORCID
  2. Uta Lehmann: School of Public Health, University of the Western Cape, Cape Town, South Africa.
  3. Helen Schneider: School of Public Health, University of the Western Cape, Cape Town, South Africa.

Abstract

The unifying theme of the papers in this series is a concern for understanding the everyday practice of governance in low- and middle-income country (LMIC) health systems. Rather than seeing governance as a normative health system goal addressed through the architecture and design of accountability and regulatory frameworks, these papers provide insights into the real-world decision-making of health policy and system actors. Their multiple, routine decisions translate policy intentions into practice - and are filtered through relationships, underpinned by values and norms, influenced by organizational structures and resources, and embedded in historical and socio-political contexts. These decisions are also political acts - in that they influence who accesses benefits and whose voices are heard in decision-making, reinforcing or challenging existing institutional exclusion and power inequalities. In other words, the everyday practice of governance has direct impacts on health system equity.The papers in the series address governance through diverse health policy and system issues, consider actors located at multiple levels of the system and draw on multi-disciplinary perspectives. They present detailed examination of experiences in a range of African and Indian settings, led by authors who live and work in these settings. The overall purpose of the papers in this series is thus to provide an empirical and embedded research perspective on governance and equity in health systems.

Keywords

References

  1. Soc Sci Med. 2006 Feb;62(4):858-65 [PMID: 16099574]
  2. Health Policy Plan. 2008 Sep;23(5):308-17 [PMID: 18701552]
  3. PLoS Med. 2011 Aug;8(8):e1001073 [PMID: 21857809]
  4. PLoS Med. 2011 Aug;8(8):e1001079 [PMID: 21886488]
  5. Health Policy Plan. 2014 Sep;29(6):685-93 [PMID: 23411121]
  6. BMC Health Serv Res. 2013 Aug 16;13:320 [PMID: 23953492]
  7. Health Policy Plan. 2015 Oct;30(8):957-63 [PMID: 25161271]
  8. Health Policy Plan. 2014 Sep;29 Suppl 2:ii29-39 [PMID: 25274638]
  9. Int J Equity Health. 2016 Dec 9;15(1):202 [PMID: 27938374]
  10. Int J Equity Health. 2017 Feb 21;16(1):26 [PMID: 28219429]
  11. Int J Equity Health. 2017 Feb 21;16(1):35 [PMID: 28222728]
  12. Health Policy Plan. 2017 Jun 1;32(5):710-722 [PMID: 28334991]
  13. Int J Health Policy Manag. 2017 Apr 04;6(8):431-435 [PMID: 28812842]
  14. Int J Equity Health. 2017 Sep 15;16(1):159 [PMID: 28911323]
  15. Int J Equity Health. 2017 Sep 15;16(1):72 [PMID: 28911324]
  16. Int J Equity Health. 2017 Sep 15;16(1):151 [PMID: 28911325]
  17. Int J Equity Health. 2017 Sep 15;16(1):84 [PMID: 28911327]
  18. Int J Equity Health. 2017 Sep 15;16(1):169 [PMID: 28911328]
  19. Int J Equity Health. 2017 Sep 15;16(1):113 [PMID: 28911332]
  20. Int J Equity Health. 2017 Sep 15;16(1):85 [PMID: 28911337]
  21. Int J Equity Health. 2017 Sep 15;16(1):164 [PMID: 28911338]
  22. Health Policy Plan. 2017 Nov 1;32(9):1337-1344 [PMID: 28981658]
  23. BMJ Glob Health. 2017 Jul 20;2(2):e000343 [PMID: 29225938]

MeSH Term

Delivery of Health Care
Developing Countries
Health Equity
Humans

Word Cloud

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