governance

MSH Vice President, Pharmaceuticals & Health Technologies Group, Dr. Douglas Keene, tells Devex how strong governance enables access to medicines.MSH Vice President, Pharmaceuticals & Health Technologies Group, Dr. Douglas Keene, tells Devex how strong governance enables access to medicines.

This week, Management Sciences for Health (MSH) and Devex are talking about how to maximize the impact of access to medicines in low- and middle-income countries. Below are excerpts, descriptions, videos, and links to the conversation. See the full conversation on Access to Medicines.

By strengthening governance and promoting transparency, developing countries can be better equipped to regulate the flow of medicines and support their efficient and effective use. Countries could make much progress by assuring the quality of medicines, but what is really being achieved in practice?

Recent global crises such as Ebola and Zika have revealed the dangers of weak health systems. As countries work to strengthen these systems, Dr. Douglas Keene, vice president of the pharmaceuticals & health technologies group at MSH, advises policymakers to first start by addressing existing regulations and governance.

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

Medicines are a critical component of quality health care. In fact, most of the leading causes of death and disability in low- and middle-income countries could be prevented or treated with the appropriate use of affordable, effective medicines.

Yet, about two billion people—one third of the world’s population—lack consistent access to essential medicines. Fake and substandard medicines exacerbate the problem. When these people fall ill and seek treatment, too often they end up with small quantities, high prices, poor quality, and the wrong drug. This leads to prolonged suffering, and even death.

Management Sciences for Health (MSH) is a global leader on pharmaceutical management and universal health coverage (UHC). 

 {Source: Management Sciences for Health (MSH)}Illustration of a typical discussion in a public hospital governing board.Source: Management Sciences for Health (MSH)

This post originally appeared on K4Health's Blog and the Leadership, Management & Governance (LMG) Project Blog.

I struggled with the plateauing or even declining performance of a health service delivery organization I was supporting. I agonized over weaning another such organization away from relying on aid and becoming self-reliant. I spent sleepless nights wondering why yet another health sector organization was adrift, and how I could help it get onto a steady course and in a definitive direction.

Increasingly, I am convinced that the answer lies in improving how these organizations are governed.

{Photo credit: Jawad Jalali-Afghan Eyes}Photo credit: Jawad Jalali-Afghan Eyes

Update, July 30, 2015:

Prior to 2002, the vast majority of health service delivery systems in Afghanistan were non-existent or informal. The Leadership, Management, and Governance (LMG)-Afghanistan project improved family planning, reproductive health, and maternal and child health using strategies to strengthen health leadership developed by Afghans, for Afghans.

See the Journey to Restoration on Exposure

The original post follows:

{Photo credit: Katy Doyle/MSH, West Africa}Photo credit: Katy Doyle/MSH, West Africa

The following blog post is a web-formatted version of MSH's Global Health Impact newsletter (June 2015 edition), Good Governance Strengthens Health Systems. We welcome your questions and feedback in the comments. Get Global Health Impact in your inbox

Notes

by James A. Rice, PhD

What do we mean by governance? Governance is a structured process used by a group of people—often referred to as a governing body, board, or council—to make decisions about policy, plans, and rules of collective action for an organization or system. For health organizations, the focus of this collective action is strengthening health systems to expand access to quality health services and achieve sustainable gains in health outcomes.

{Photo credit: Rui Pires}Photo credit: Rui Pires

While at the World Federation of Public Health Associations meeting in India earlier this year, I met with a district health manager from Nigeria. He asked,

What is the value of having a District Health Council? It takes a lot of time to work with them; so what is the return on that invested time?

My Nigerian colleague is not the only one struggling to support the role of governing bodies. For years, governing bodies -– from district and provincial health councils to executive boards -– have been overlooked as valuable players in strengthening health systems.

“There are many examples of how investments in good governance lead to better health outcomes,” I said, “and many opportunities for supporting the under-supported leaders who govern through district health councils, hospital boards, or other governing bodies.”

We talked about how in the journey to stronger health system performance and greater health outcomes, it is not enough to have good leaders and managers to enable the talents of good health workers.

Strong health systems also need strong trustees serving on the organization’s governing body.

We determined that a good district health council -– or any good governing body –- amplifies the investment of time in at least three ways:

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

The benefits of good health governance are far-reaching: Leaders who govern facilitate the work of health managers. Health managers facilitate the work of health service providers.
- Management Sciences for Health

On May 11-13, 2015, the USAID-funded Leadership, Management & Governance (LMG) Project, led by Management Sciences for Health (MSH), conducted an online seminar on LeaderNet titled Unleash the Power of Good Governance. Over the three-day seminar, 93 participants representing 75 organizations in 36 countries discussed challenges to good governance among public and civil society organizations, and how to overcome them. The seminar was offered in three languages: English, French and Spanish, and encouraged learning through source materials, the facilitators, and one another.

Three themes emerged from among the online discussion threads:

{Photo credit: Warren Zelman.}Photo credit: Warren Zelman.

Nearly three years ago, I blogged about a systems approach to improving access for a Maternal Health Task Force (MHTF) series on maternal health commodities:

Increasing access to essential medicines and supplies for maternal health requires a systems approach that includes: improving governance of pharmaceutical systems, strengthening supply chain management, increasing the availability of information for decision-making, developing appropriate financing strategies and promoting rational use of medicines and supplies.

{Photo credit: Mark Tuschman.}Photo credit: Mark Tuschman.

Good governance of a health system enables sound management of medicines, health information, human resources, and finances. Good governance enables health providers to deliver better health service performance which leads to better health outcomes. 

In this series, hosted by The Leadership, Management and Governance (LMG) Project, our speakers will: 

  • Discuss the factors that constrain governance effectiveness in service delivery organizations 
  • Explore solutions to the governance challenges using real life examples
  • Review tools, techniques, and approaches that will help you overcome your own governance challenges

Register now

 {Photo credit: Sarah Lindsay/MSH.}Ayanda Ntsaluba (right) Executive Director of Discovery Health and Former Director-General of Health for South Africa, welcomes participants to the Third Global Governance for Health Roundtable.Photo credit: Sarah Lindsay/MSH.

Management Sciences for Health (MSH) and a consortium of partners lead the US Agency for International Development's (USAID's) Leadership, Management & Governance (LMG) Project. These posts originally appeared on LMG's blog as two posts (Day 1 and Day 2). They also appeared on MSH's Third Global Symposium on Health Systems Research conference blog (Day 1, Day 2).

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