PAPER: Linking governance mechanisms to health outcomes
[Facilitator's note: Thank you to Taryn Vian, Associate Professor of International Health, MBA-MPH Dual Degree Program in Global Health Management, Boston University School of Public Health, for sharing this information.]
Linking Governance Mechanisms to Health Outcomes: A review of the literature in low- and middle-income countries
Dana Karen Ciccone, Taryn Vian, Lydia Maurer, Elizabeth H. Bradley
Abstract:
We conducted a synthesis of peer-reviewed literature to shed light on links between governance mechanisms and health outcomes in low- and middle-income countries. Our review yielded 30 studies, highlighting four key governance mechanisms by which governance may influence health outcomes in these settings: Health system decentralization that enables responsiveness to local needs and values; health policymaking that aligns and empowers diverse stakeholders; enhanced community engagement; and strengthened social capital. Most, but not all, studies found a positive association between governance and health. Additionally, the nature of the association between governance mechanisms and health differed across studies. In some studies (N=9), the governance effect was direct and positive, while in others (N=5), the effect was indirect or modified by contextual factors. In still other studies (N=4), governance was found to have a moderating effect, indicating that governance mechanisms influence other system processes or structures that improved health. The remaining studies reported mixed findings about the association between governance and health (N=6), no association between governance and health (N=4), or had inconclusive results (N=2). Further exploration is needed to fully understand the relationship between governance and health and to inform the design and delivery of evidence-based, effective governance interventions around the world.
This article was recently published in Social Science and Medicine.
Social Science & Medicine, Volume 117, September 2014, Pages 86–95.
http://www.sciencedirect.com/science/article/pii/S0277953614004390
Author’s copy of full text can be obtained by writing to Taryn Vian at tvian@bu.edu
Linking Governance Mechanisms to Health Outcomes: A review of the literature in low- and middle-income countries
Dana Karen Ciccone, Taryn Vian, Lydia Maurer, Elizabeth H. Bradley
Abstract:
We conducted a synthesis of peer-reviewed literature to shed light on links between governance mechanisms and health outcomes in low- and middle-income countries. Our review yielded 30 studies, highlighting four key governance mechanisms by which governance may influence health outcomes in these settings: Health system decentralization that enables responsiveness to local needs and values; health policymaking that aligns and empowers diverse stakeholders; enhanced community engagement; and strengthened social capital. Most, but not all, studies found a positive association between governance and health. Additionally, the nature of the association between governance mechanisms and health differed across studies. In some studies (N=9), the governance effect was direct and positive, while in others (N=5), the effect was indirect or modified by contextual factors. In still other studies (N=4), governance was found to have a moderating effect, indicating that governance mechanisms influence other system processes or structures that improved health. The remaining studies reported mixed findings about the association between governance and health (N=6), no association between governance and health (N=4), or had inconclusive results (N=2). Further exploration is needed to fully understand the relationship between governance and health and to inform the design and delivery of evidence-based, effective governance interventions around the world.
This article was recently published in Social Science and Medicine.
Social Science & Medicine, Volume 117, September 2014, Pages 86–95.
http://www.sciencedirect.com/science/article/pii/S0277953614004390
Author’s copy of full text can be obtained by writing to Taryn Vian at tvian@bu.edu