The Demise and Rise of Governance in Health Systems: A Path Forward
Abstract/Contents
- Abstract
- How can global health initiatives (GHIs) focused on funding service provision in the short term simultaneously encourage indigenous health governance? This thesis first offers a taxonomy of nine mechanisms at the community, district, and national levels identified from the literature as capable of improving health governance. Second, it utilizes the proposed taxonomy to evaluate the funding patterns of one GHI – the Global Fund to Fight AIDS, Tuberculosis and Malaria. Analysis of the first nine rounds of Global Fund grants awarded to 123 countries revealed that the Global Fund appears to base its funding decisions upon need – high disease burden and low GDP per capita – rather than on quality of governance. Upon further examination, a complicated relationship exists between grant size and disease burden with countries facing the greatest disease prevalence paradoxically receiving relatively fewer dollars per case than other recipient countries. The governance-improving activities offered in the taxonomy appeared in less than one-half, and in most cases less than one-fifth, of 287 grants analyzed from forty countries. This insufficient emphasis on governance improvement is likely due to an overriding emphasis on vertical disease eradication driven by donor demands of short term results rather than on broadly strengthening health systems for which measurement of results is more difficult and outcomes are slower to develop. Inadequate investment in governance threatens to hamper progress towards the health Millennium Development Goals and to jeopardize sustainability of short term improvements in health outcomes, especially as developing countries with large disease epidemics often face poor governance.
Description
| Type of resource | text |
|---|---|
| Date created | May 21, 2011 |
Creators/Contributors
| Author | Habib, Anand R. |
|---|---|
| Advisor | Wise, Paul |
Subjects
| Subject | CISAC |
|---|---|
| Subject | Center for International Security and Cooperation |
| Subject | Stanford University |
| Subject | global health |
| Subject | health governance |
| Genre | Thesis |
Bibliographic information
Access conditions
- Use and reproduction
- User agrees that, where applicable, content will not be used to identify or to otherwise infringe the privacy or confidentiality rights of individuals. Content distributed via the Stanford Digital Repository may be subject to additional license and use restrictions applied by the depositor.
- License
- This work is licensed under a Creative Commons Attribution Non Commercial 3.0 Unported license (CC BY-NC).
Preferred citation
- Preferred Citation
- Habib, Anand R. (2011). The Demise and Rise of Governance in Health Systems: A Path Forward. Stanford Digital Repository. Available at: http://purl.stanford.edu/zn638tj5948
Collection
Stanford University, Center for International Security and Cooperation, Interschool Honors Program in International Security Studies, Theses
View other items in this collection in SearchWorksContact information
- Contact
- anand.habib@gmail.com
Also listed in
Loading usage metrics...