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Practicing governance towards equity in health systems: LMIC perspectives and experience

New Content ItemEdited by Prof Lucy Gilson and Dr Ana Lorena Ruano
International Journal for Equity in Health

The unifying theme of the papers in this series is a concern for understanding the everyday practice of governance in LMIC health systems. 

Rather than seeing governance as a normative health system goal addressed through the architecture and design of accountability and regulatory frameworks, these papers provide insights into the real-world decision-making of health policy and system actors. Their multiple, routine decisions translate policy intentions into practice – and are filtered through relationships, underpinned by values and norms, influenced by organizational structures and resources, and embedded in historical and socio-political contexts. These decisions are also political acts – in that they influence who accesses benefits and whose voices are heard in decision-making, reinforcing or challenging existing institutional exclusion and power inequalities. In other words, the everyday practice of governance has direct impacts on health system equity.

The papers in the series address governance through diverse health policy and system issues, consider actors located at multiple levels of the system and draw on multidisciplinary perspectives. They present detailed examination of experiences in a range of African and Indian settings, led by authors who live and work in these settings. The overall purpose of the papers in this series is thus to provide an empirical and embedded research perspective on governance and equity in health systems. 

The papers were discussed at an April 2016 workshop hosted by the Collaboration for Health Systems Analysis and Innovation (CHESAI) in Cape Town, South Africa. They were sponsored either by CHESAI, with funding from the International Development Research Centre, Canada, or by the Resilient and Responsive Health Systems Consortium (RESYST), with funding from the UK’s Department for International Development. All articles have undergone the journal’s standard peer review process. The Editors declare no competing interests.

Read the associated blog: "Challenging health system inequity by practicing everyday governance"

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