Leadership and Governance
Leadership and Governance
Leadership and Governance
System
Framework
and
Building
Blocks
LEADERSHIP AND
GOVERNANCE
WHO-BUILDING
BLOCKS OF HEALTH
SYSTEM The six building blocks
contribute to the strengthening of
health systems in different ways.
leadership/governance and health
information systems, provide the
basis for the overall policy and
regulation of all the other health
system blocks. Key input
components to the health system
include financing and the health
workforce. A third group, namely
medical products, technologies
and service delivery, reflects the
immediate outputs of the health
system, i.e. the availability and
distribution of care.
LEADERSHIP
Effective leadership ensures the existence of strategic policy frameworks, effective
oversight and coalition-building, provision of appropriate incentives and attention to
system design and accountability.
Dimensions of good leadership/Governance are:
RESPONSIVENESS- INTEGRITY-
linking health policy promoting ethical
and expenditures with management and
public priorities standards among health
professionals.
OVERSIGHT- ACCOUNTABILTY-
TRANSPARENCY- clarifying delineation
conducting regular
increasing public access of authorities for
reviews of the results of
to health health programming
health investments
and expenditure
GOVERNANCE
WHAT IS GOVERNANCE ?
GOVERNANCE IS “ensuring strategic policy frameworks exist and are combined with effective oversight, coalition
building, the provision of appropriate regulations and incentives, attention to system-design, and accountability“
Governance in the health sector refers to a wide range of steering and rule-making related functions carried out by
governments/decisions makers as they seek to achieve national health policy objectives that are conducive to
universal health coverage. Governance is a political process that involves balancing competing influences and
demands. It includes:
measure whether countries have appropriate policies, strategies and codified approaches for health system governance. In
the health systems context, these indicators include the existence, for example, of a national essential medicines list or a
national policy on malaria control. They are part of a larger class of indicators called governance determinants
OUTCOME-BASED INDICATORS
measure whether rules and procedures are being effectively implemented or enforced, based on the experience of
relevant stakeholders. For health systems, examples may include the availability of essential medicines in health
facilities or the absenteeism of health workers
CORE INDICATOR : TUBERCULOSIS
In March 2017, the
Government of India (GoI) announced that
the new aim about TB in India was
the elimination of TB by 2025. Elimination
as defined by the World
Health Organization (WHO), means that
there should be less than 1 person with TB for
a population of a million people.
WHAT COULD YOUR COUNTRY ACHIEVE BY FOCUSING ON
GOVERNANCE AND LEADERSHIP
When done effectively, improved governance & leadership can contribute to an array of
downstream effects including:
INPUTS:
SYSTEM: Drugs & SERVICE ACCESS:
Governance & supplies. DELIVERY: Availability of OUTCOMES:
effective policy OUTPUT:
leadership. Facility Population Health status,
health care EFFECTIVE responsiveness to
Health financing. infrastructure. health services SERVICE people,
Information management HIGH QUALITY COVERAGE equity, efficiency,
Adjustment to
population systems Facility PRIMARY HEALTH resilience of health
health Workforce organization CARE system.
Funds
CORE INDICATORS:HIV HEALTH-
EXISTENCE OF A NATIONAL HIV
STRATEGY OR POLICY
UNGASS INDICATORS IS THE NATIONAL COMPOSITE POLICY INDEX
VISION –a world with zero HIV case by 2030
GOAL of national HIV strategy is to reduce new HIV infection
Increase access to care and optimize health outcomes for people living with HIV
Reduce HIV related heath disparities and health inequalities
FRAMEWORK FOR ELIMINATING HIV BY 203
1.By testing and treatment
Ensure that 90% of people living with
HIV knows their HIV status.
Ensure that 90% of people living with
HIV know their HIV status
Ensure that 90% of people living with
HIV ,and who are on treatment achieve
viral load suppression.
2.Financial sustainability
3.Innovation
FRAMEWORK FOR
Reported
ELIMINATING malaria
cases per
WHO
In November 2015,the
Prime minister of India
joined 17 Asia pacific
leaders in endorsing a
plan and roadmap to
eliminate malaria
INTERVENTIONS
The speed and scope of the coronavirus crisis poses extraordinary challenges for leaders in today’s vital institutions.
On March 11, 2020, the spread of the SARS-CoV-2 was declared a pandemic by the World Health Organization. World
leaders, healthcare executives and clinical leads struggled to establish ‘best practice’ models and strategies.
Leadership compartmentalisation-
Planning and coordination
Situation monitoring and assessment
Communication
Funding, PPE and testing
Mitigation and containment
Predictive mathematical modelling
COVID-19 surgical adaptation phases
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366988/
EXEMPLAR LEADERSHIP:
South Korea became the second most infected country after China by early March. To handle the pandemic, they undertook a massive
public and private sector effort to fashion a national response. They controlled their outbreak without imposing a nationwide lockdown.
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366988/
COMPARISION OF COUNTRIES
MEASURES TAKEN DURING PANDEMIC
TAIWAN
6% of its gross GDP
f) Educating public
e) Ensuring
d) Using technology g) Learning from
availability of
to track and test past experiences
supplies
https://www.nbcnews.com/health/health-news/what-taiwan-can-teach-world-fighting-coronavirus-n1153826
UNITED STATES
17% of US GDP
DRAWBACKS :
a) initial unresponsiveness
b) failed implementation
https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019
https://www.cfr.org/backgrounder/comparing-six-health-care-systems-pandemic
KERALA
Stanford University ranked Kerala as second-best performing state
pathbreaking planning and action
.
number of tests increased significantly
involvement of government
education on health
CASE STUDY OF
INDIAN UT DELHI ON
LEADERSHIP AND
POLITICAL WILL
TOWARDS HEALTH
SECTOR
Budget Allocation
Strengthening healthcare system by network of
Mohalla clinic, polyclinic and tertiary care
hospital
Free medication and free 30 surgery in every
government hospital
Bike ambulance
Campaign for dengue
#10hafte_10din_10bje
Responsive helpline 1031 for complain and
suggestions
POOR GOVERNANCE AND LEADERSHIP
PRACTICES IN INDIA
Health workforce Absenteeism from public sector, bribe for transfers, promotion
LET’S ROOT FOR EACH OTHER AND WATCH EACH OTHER GROW
THANK YOU