Health Governance

“Steering Not Rowing”

The healthcare system has become a complex structure that requires immense human and financial resources. Furthermore, the rapid increase in knowledge through basic and applied research is constantly challenging decision makers and clinicians to continuously evaluate the effectiveness and efficiency of these new discoveries and how to integrate them in the current system. It is also clear to us all that current and future practices although usually adopted because of their proven benefit have inherit risks to the system and the community. These risks affect us directly as healthy individuals and as patients when we unfortunately fall ill. They also affect us indirectly when our organizations and healthcare providers take decisions that are not appropriate to our values and preferences.

In this context, governance, has emerged as a framework that can help introduce and ensure shared responsibility and accountability between the providers of the health services and care and the beneficiaries from the community. This is usually achieved through maximizing mutual participation in the setting of direction and priorities and ensuring performance through scientific and transparent processes.

Application of governance in the healthcare system has taken many forms and levels depending on the specific area it is targeting. Examples include clinical governance, institutional governance, system governance, research governance, etc. However, they all aim at ensuring high performance within a participatory and accountable environment based on sound research evidence.

It is with these principles in mind that the Medical Research Institute, Alexandria University has established a Health Governance Unit within its structure to help create a critical awareness to the importance of governance in our academic and wider community and present the tools for its implementation through its annual courses and workshops. The unit and its human capacity was built and developed with the help of a fund from the Egyptian-Italian Dept for Development Swap Program and with the technical help from the Istituto Superiore di Sanità, Rome Italy.

To initiate its activity the Health Governance Unit has performed a stakeholder analysis in Alexandria related to health governance which showed that most stakeholders see governance as a positive addition. Naturally, this will not be free of challenges as the analysis also indicated that there is limited awareness on governance and how to implement it. In addition to these facts, the feedback from participants of the unit courses and workshops has constantly emphasized the need and importance of practicing good governance in the health sector.