Table 1.
Siddiqi et al.’s [30] governance framework principles
| Principle | Domains |
|---|---|
| Strategic vision | |
| Leaders have a broad and long-term perspective on health and human development, along with a sense of strategic directions for such development. There is also an understanding of the historical, cultural and social complexities in which that perspective is grounded | Long-term vision; comprehensive development strategy including health |
| Participation & consensus orientation | |
| All men and women should have a voice in decision-making for health, either directly or through legitimate intermediate institutions that represent their interests. Such broad participation is built on freedom of association and speech, as well as capacities to participate constructively. Good governance of the health system mediates differing interests to reach a broad consensus on what is in the best interests of the group and, where possible, on health policies and procedures | Participation in decision-making process; stakeholder identification and voice |
| Rule of law | |
| Legal frameworks pertaining to health should be fair and enforced impartially, particularly the laws on human rights related to health | Legislative process; interpretation of legislation to regulation and policy; enforcement of laws and regulations |
| Transparency | |
| Transparency is built on the free flow of information for all health matters. Processes, institutions and information should be directly accessible to those concerned with them, and enough information is provided to understand and monitor health matters | Transparency in decision-making; transparency in allocation of resources |
| Responsiveness | |
| Institutions and processes should try to serve all stakeholders to ensure that the policies and programs are responsive to the health and non-health needs of its users | Response to population health needs; response to regional local health needs |
| Equity | |
| All men and women should have opportunities to improve or maintain their health and well-being | Equity in access to care; fair financing of health care; disparities in health |
| Effectiveness & efficiency | |
| Processes and institutions should produce results that meet population needs and influence health outcomes while making the best use of resources | Quality of human resources; communication processes; |
| capacity for implementation | |
| Accountability | |
| Decision-makers in government, the private sector and civil society organizations involved in health are accountable to the public, as well as to institutional stakeholders. This accountability differs depending on the organization and whether the decision is internal or external to an organization | Accountability: internal; accountability: external |
| Intelligence & information | |
| Intelligence and information are essential for a good understanding of health system, without which it is not possible to provide evidence for informed decisions that influences the behaviour of different interest groups that support, or at least do not conflict with, the strategic vision for health | Information: generation, collection, analysis, dissemination |
| Ethics | |
| The commonly accepted principles of health care ethics include respect for autonomy, nonmaleficence, beneficence and justice. Health care ethics, which includes ethics in health research, is important to safeguard the interest and the rights of the patients | Principles of bioethics; health care and research ethics |
(Adapted from Siddiqi et al. [30])