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Towards people-centred health systems: a multi-level framework for analysing primary health care governance in low- and middle-income countries.

Abimbola S, Negin J, Jan S, Martiniuk A - Health Policy Plan (2014)

Bottom Line: Although there is evidence that non-government health system actors can individually or collectively develop practical strategies to address primary health care (PHC) challenges in the community, existing frameworks for analysing health system governance largely focus on the role of governments, and do not sufficiently account for the broad range of contribution to PHC governance.We apply the framework to PHC because, like common-pool resources, PHC facilities in LMICs tend to be commonly owned by the community such that individual and collective action is often required to avoid the 'tragedy of the commons'-destruction and degradation of the resource resulting from lack of concern for its continuous supply.We demonstrate the potential impact of health system actors functioning at different levels of governance on PHC delivery, and how governance failure at one level can be assuaged by governance at another level.

View Article: PubMed Central - PubMed

Affiliation: National Primary Health Care Development Agency, Abuja, Nigeria, School of Public Health, University of Sydney, Australia, The George Institute for Global Health, University of Sydney, Australia and Dalla Lana School of Public Health, University of Toronto, Canada National Primary Health Care Development Agency, Abuja, Nigeria, School of Public Health, University of Sydney, Australia, The George Institute for Global Health, University of Sydney, Australia and Dalla Lana School of Public Health, University of Toronto, Canada National Primary Health Care Development Agency, Abuja, Nigeria, School of Public Health, University of Sydney, Australia, The George Institute for Global Health, University of Sydney, Australia and Dalla Lana School of Public Health, University of Toronto, Canada seyeabimbola@hotmail.com.

No MeSH data available.


Related in: MedlinePlus

The multi-level framework for PHC governance in LMICs. Note: The actors that occupy each level of governance vary with the policy issue or objective of analysis. In this rendering of the framework, PHC providers are at the operational level, communities are at the collective level and governments are at the constitutional level. Other renderings of the multi-level framework may have or include individual service users at the operational level, specific community groups at the collective level or large NGOs and similar organizations at the constitutional level.
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czu069-F1: The multi-level framework for PHC governance in LMICs. Note: The actors that occupy each level of governance vary with the policy issue or objective of analysis. In this rendering of the framework, PHC providers are at the operational level, communities are at the collective level and governments are at the constitutional level. Other renderings of the multi-level framework may have or include individual service users at the operational level, specific community groups at the collective level or large NGOs and similar organizations at the constitutional level.

Mentions: The components of the framework consist of three levels of PHC governance. Figure 1 shows a simplified version of a complex set of interactions among the three levels of governance. These levels are defined as operational governance, collective governance and constitutional governance:


Towards people-centred health systems: a multi-level framework for analysing primary health care governance in low- and middle-income countries.

Abimbola S, Negin J, Jan S, Martiniuk A - Health Policy Plan (2014)

The multi-level framework for PHC governance in LMICs. Note: The actors that occupy each level of governance vary with the policy issue or objective of analysis. In this rendering of the framework, PHC providers are at the operational level, communities are at the collective level and governments are at the constitutional level. Other renderings of the multi-level framework may have or include individual service users at the operational level, specific community groups at the collective level or large NGOs and similar organizations at the constitutional level.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4202919&req=5

czu069-F1: The multi-level framework for PHC governance in LMICs. Note: The actors that occupy each level of governance vary with the policy issue or objective of analysis. In this rendering of the framework, PHC providers are at the operational level, communities are at the collective level and governments are at the constitutional level. Other renderings of the multi-level framework may have or include individual service users at the operational level, specific community groups at the collective level or large NGOs and similar organizations at the constitutional level.
Mentions: The components of the framework consist of three levels of PHC governance. Figure 1 shows a simplified version of a complex set of interactions among the three levels of governance. These levels are defined as operational governance, collective governance and constitutional governance:

Bottom Line: Although there is evidence that non-government health system actors can individually or collectively develop practical strategies to address primary health care (PHC) challenges in the community, existing frameworks for analysing health system governance largely focus on the role of governments, and do not sufficiently account for the broad range of contribution to PHC governance.We apply the framework to PHC because, like common-pool resources, PHC facilities in LMICs tend to be commonly owned by the community such that individual and collective action is often required to avoid the 'tragedy of the commons'-destruction and degradation of the resource resulting from lack of concern for its continuous supply.We demonstrate the potential impact of health system actors functioning at different levels of governance on PHC delivery, and how governance failure at one level can be assuaged by governance at another level.

View Article: PubMed Central - PubMed

Affiliation: National Primary Health Care Development Agency, Abuja, Nigeria, School of Public Health, University of Sydney, Australia, The George Institute for Global Health, University of Sydney, Australia and Dalla Lana School of Public Health, University of Toronto, Canada National Primary Health Care Development Agency, Abuja, Nigeria, School of Public Health, University of Sydney, Australia, The George Institute for Global Health, University of Sydney, Australia and Dalla Lana School of Public Health, University of Toronto, Canada National Primary Health Care Development Agency, Abuja, Nigeria, School of Public Health, University of Sydney, Australia, The George Institute for Global Health, University of Sydney, Australia and Dalla Lana School of Public Health, University of Toronto, Canada seyeabimbola@hotmail.com.

No MeSH data available.


Related in: MedlinePlus