Health Governance

By Dr.Noha Gaber Elkmash

 What is Health?
Health is a state of complete physical, mental, social wellbeing
and not merely the absence of disease or infirmity.
What is Health System?
All organizations,
people and activities
whose primary intent is
to promote, restore or
maintain health.
 WHO Health Systems Framework
System Building Blocks
Overall Goals and Outcomes
Service Delivery
Improved Health &
Equity
Health Workforce Access
Coverage
Responsiveness
Information
System
Quality Financial
Health Technology Safety Protection

Finance Efficiency

Leadership &
Governance
System Building Blocks

Service Delivery
Ensuring strategic frameworks exist
and combined with effective oversight
Health Workforce
, the provision of regulations and
Information incentives , and accountability.
System

Health Technology

Finance

Leadership &
Governance
System Building Blocks

Service Delivery
Having enough funds in ways
Health Workforce that ensure people can use
needed services , and are
Information
System protected from financial
catastrophe.
Health Technology

Finance

Leadership &
Governance
System Building Blocks

Service Delivery Ensuring access to any intervention

has effect on health improvement ,
Health Workforce are used to diagnose or treat patient (
medications, vaccines and
Information
System
instrumentation).
Health
Technology

Finance

Leadership &
Governance
  Very important to identify the problems and needs , make
System Building Blocks
evidence- based decisions on health policy, and allocate
resources optimally .
Service Delivery  It is digital system (computerized) used to acquire, store,
transmit, analyze and present information .
 Its benefits :- ensures accuracy of data and reduces any
Health Workforce chance of medical errors, it saves time and effort( can focus
more on patient treatment and follow-up), faster
prescriptions and reduces paperwork, enables
Information System communication ( share data across different departments).
 Examples:- Electronic Medical Record (EMR),Medical
Billing Software, E- Prescribing Software, Master Patient
Health Technology Index(MPI).
Life cycle :- Needs assessment.
System selection.
Finance Implementation.
Maintenance.
Leadership &
Governance
System Building Blocks

Service Delivery
All medical staff or healthcare team ( sufficient
number, fairly distributed, competent and
Health Workforce
productive)
Information
System

Health Technology

Finance

Leadership &
Governance
System Building Blocks

Service Delivery  Primary health care and hospitals .

 Delivery of series of interventions
personal (preventive, diagnostic,
Health Workforce
therapeutic ) and non personal ( basic
Information
sanitation , health promotion ,
System occupational safety and road traffic
safety).
Health Technology

Finance

Leadership &
Governance
 WHO Health Systems Framework
System Building Blocks
Overall Goals and Outcomes
Service Delivery
Improved Health &
Equity
Health Workforce Access
Coverage
Responsiveness
Information
System
Quality Financial
Health Technology Safety Protection

Finance Efficiency

Leadership &
Governance
 What is Governance?
 Meaning “to steer“
 Action of governing a state , organization , …etc.
 System by which an organization is directed , overseen & held
accountable for achieving its defined purpose.
 Is the process of insuring that health systems are accountable ,
transparent , efficient & responsive to the needs & preferences of the
people they serve.
 Rules that distribute roles and responsibilities among societal actors.
 Societal Actors

State

Citizen Provider
 Governance Management
Sets the strategic direction Implements the strategies to
and accountability for the achieve the goals through
organisation. day-to-day operations.
 Accountability
 All decision – makers and individuals take responsibility for their
decisions & commitment to provide quality services &
safeguarding high standards of care.
 Information on performance.
 Rule Of Law
• Ensure that decisions and activities do not breach the
boundaries of law.
 Transparency
• There is public access to all information.
• Reporting system.
 Consensus Orientation
• Determining the role of different departments of the
government towards improvement of health .
• Majority ruling accepted as one of the forms used to
reach a decision.
 Responsiveness
• Responsible individuals should respond to the expectations
and needs of the people in a positive and timely manner.
 Effectiveness And Efficiency
• Effectiveness of services offered by organizations .
• Efficiency by saving on unnecessary costs.
 Participation
Partnership among practitioners, patients, and their families, to ensure that decisions respect
patients’ wants, needs, and preferences and that patients have the education and support they
need to make decisions and participate in their own care.

Patient information by :- leaflets or videos. - posters - encourage asking questions

- design easy to read educational material. -"teach-back"
Shared decision making :- patient should work together with clinician to select tests,
treatments and management based on best available evidence.
 Equity
 Equity means social justice or fairness .
 Equity focuses on ensuring and treating those who
require care in ways that are appropriate to what
they need to enjoy full, healthy lives.
 Equity aims to remove unjust and unnecessary
differences.
 This require us to consider the possibility of making
different arrangements of resource allocating.

Equality ≠ Equity
Egypt vision 2030 Health goals

The improvement of the health of citizens

within a framework of justice and equity

Achieve universal healthcare coverage

for all Egyptians and ensure high quality

Improve health sector governance

 Universal Health Coverage
Ensure all people have access to needed services
without the risk of financial hardship
linked to paying for care.
 Health System Reforms In Egypt
• Adopting Purchaser Provider Split through restructuring health care
system into three main components:
•Purchaser/Payer – General authority of Health Insurance.
•Providers – General authority for healthcare provider organizations .
•Accreditation and regulation – General Authority for Healthcare
Accreditation and Regulation (GAHAR).
THANK YOU