Effects Of Good Governance on Health System Performance: An empirical analysis of the WHO Europe region

Context

Governance in the health sector has gained more attention in the recent literature, although, the topic is still relatively under-examined. The WHO European Region comprises 53 member states that each have unique health systems, HWF planning and governance characteristics. These countries are struggling to develop optimal approaches to strengthen health systems and improve performance outcomes amidst local contexts, lack of financial resources, and varying supply and demand of health workers. While it has been widely recognized that a one-size-fits all approach cannot be successful and each country requires specific, context-bound solutions, it is also evident that there are certain key features and elements, or general enablers for a more successful health system performance. Good Governance should be regarded as one of such, and is possibly the most critical general enabler of a better functioning healthcare system.

Methods

To test this proposition, we use a set of universal indicators from publicly accessible data bases that were analysed in Microsoft Excel using its Pearsons correlation coefficient function for the sets of data pairs to identify an association between governance and health performance.

Findings

We found a positive association with variable strength between the variables’ pairs. We corroborated these findings with country clusters based on the other five WHO regions, where we also found the association found in Europe holds, also with some variation between clusters.

Conclusions

These results reveal that while linking governance to health system performance is a difficult task, there is an observable association that should be further studied.

POLICY POINTS

• Governance is generally acknowledged as important for health system performance, though there is little empirical validation of this association.

• An association is confirmed in WHO Europe region countries in our study and by way of corroboration, in other WHO region country clusters.

• There is variation of the association country by country indicating that context matters and this requires further research.