Listen In: Voices from The Third Global Governance for Health Roundtable

Sarah Lindsay, Senior Technical Officer, LMG

Prior to the Third Global Symposium on Health Systems Research in Cape Town, South Africa, the Leadership, Management & Governance (LMG) Project convened health leaders from around the world for the Third Global Governance for Health Roundtable.

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: MSH

“One thing that we have learned in the last decade is the significant importance of leadership, management, and governance to health infrastructure,” said Noddy Jinabhai, Adjunct Professor, School of Health Sciences at the University of Fort Hare, who co-facilitated the Roundtable.

The Roundtable consisted of seven sessions over one and a half days. The first session, Measuring the Value of Health Sector Governance, was organized by the Health Finance and Governance (HFG) Project. The demand for more evidence on the impact of governance on health systems was stressed by all panelists. “We want evidence to know how to hold officials accountable, and to exercise the governance. We need to get people on the same page about how they promote good governance,” said Catherine Connor, Deputy Director of HFG.

Sessions two and three focused on how to better ensure equal access to health services and engage marginalized populations in the governance of health systems. This session raised the overarching question: Why is inclusion so hard? “It takes time and money,” said Dheepa Rajan, Technical Officer of the Department for Health Systems Governance and Financing at the World Health Organization. But, she said, “There are simple ways to ensure representativeness of a consultation. Involve the community leaders or peer group leaders in project design.” 

Politics and Health Governance, the fourth session, was organized by the Health Policy Project (HPP). Robert Ndieka, Monitoring and Evaluation Expert at the African Union Commission, urged the room to, “appreciate that we have tremendous political will that has grown since 2000 and to sustain political will, we need ministers Ministries outside the Ministry of Health to commit to health gains.”

The impact political will can have on a country’s health system was demonstrated in session five, Case studies in governing health service delivery at the local level. Devolution in Kenya was presented by Ruth Kitetu of Kenya’s Ministry of Health, and Afghanistan’s experience in health governance in the provinces and districts was presented by Mohammadullah Alishungi of HPP’s Afghanistan Office.

Session six, Investing in Good Governance as an Enabler for Health Systems Strengthening, revolved around how larger donors can support national and community-level civil society organizations (CSOs).  Marian Jacobs, Chair of the Ministerial Advisory Committee at the Academy for Leadership and Management in Health Care asked, “How do we support CSOs? How can donors work with them to build their capacity and ability to influence policy?” Treatment Action Campaign’s (TAC) Anele Yawa appealed to donors to directly fund CSOs like TAC. “The future lies on the donors and where they put their money,” Yawa said.

Wrapping up the Roundtable, multiple priorities emerged.  Going forward, there was a consensus that when looking at governance structures, there’s a need to look at who’s around the table to ensure inclusiveness. There’s also a need for practitioners to be more open to sharing evidence and innovations with each other. “We need to get as many people as possible to shape our future,” said Ayanda Ntsaluba, the Executive Director of Discovery Health.