Leadership and governance / stewardship

Governance (or stewardship) is responsible attention to something entrusted to one's care. In the context of health it refers to the wide range of functions carried out by governments in their work to achieve national health goals to improve population health while ensuring equity in access to services, quality of services, and patients' rights. Governance is also concerned with the roles and responsibilities of the public, private and voluntary sectors - including civil society - and their relationships with each other, in the provision and financing of health care in pursuit of national health goals.
Effective governance implies leadership in maintaining the strategic direction of health policy development and implementation; detecting and correcting undesirable trends and distortions; articulating the case for health in national development; regulating the behaviour of actors involved in financing and delivery of health interventions; establishing effective accountability mechanisms and promoting healthy public policy and legislation in other areas of government that impact on peoples' health. In countries that receive significant amounts of development assistance, governance will be concerned with managing these resources in ways that promote national leadership, contribute to the achievement of agreed policy goals, and strengthen national management systems. While the scope for exercising governance functions is greatest at the national level, the concept can also cover the steering role of regional and local authorities.
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