Sub-functions of health development governance | Possible data source |
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1.1 Leadership responsibilities | Conduct a survey among samples of stakeholders, e.g. civil society, health workforce. |
1.2 National health policy (NHP) | Review of NHP. |
1.3 National health strategic plan (NHSP) | Review of NHSP. |
1.4 Dissemination of NHP and NHSP | Conduct a survey among samples of public and private health sector managers at various levels of health system, e.g. headquarters, provinces/regions, and districts. The survey questionnaire should be administered to civil society organizations and partners. |
1.5 Implementation of NHSP | Review of annual health sector review reports & other monitoring & evaluation reports. Plus review of national health information systems (NHIS) data. |
2.1 Existence of health-related legislation | Review of existing health-related laws. |
2.2 Enforcement of health-related legislations | Inclusion of relevant questions in the survey mentioned in 1.4 above. |
3.1 Participation in NHP and NHSP development | Conduct a survey among parliamentarians and civic leaders or administrative leaders (especially chiefs). |
3.2 Participation in NHSP implementation | Inclusion of relevant questions in the survey mentioned in 3.1 above. |
3.3 Participation in tracking of progress | Inclusion of relevant questions in the survey mentioned in 3.1 above. |
3.4 Responsiveness to communities non-medical expectations | Exit client surveys among samples of different levels of health facilities, e.g. tertiary, provincial/regional and district hospitals, and health centres. |
4.1 Intersectoral action | In-depth interview with prime minister/president's office. |
4.2 Public-private partnerships | Review of health-related legislation & interviews of leaders of faith-based and private-for-profit health service providers. |
4.3 Alignment of aid flows to national health development priorities | Interviews with Ministry of Finance and health development partners. |
4.4 Strengthen capacity by coordinated support | Interviews with Ministry of Health regarding existence of Sector-Wide Approaches, multi-donor steering committees or equivalent mechanisms. |
4.5 Use of country procurement and public financial management systems | Review reports of the Public Expenditure and Financial Accountability (PEFA) initiative [44]. If the data does not already exist use PEFA framework [45] to conduct the assessment. |
4.6 Strengthen national capacity by avoiding parallel implementation structures | Â |
4.7 Aid is more predictable | Â |
4.8 Aid is untied | Â |
4.9 Shared analysis | Â |
4.10 Sufficient integration of global programmes and initiatives into NHSP | Interviews with Ministry of Health, Ministry of Finance, GFATM and GAVI. |
5.1 Horizontal equity | Analysis of household surveys, e.g., World Health Surveys [43], LSMS [49], DHS [50], and MICS [51]. Other sources include household budget surveys, census data, facility-based surveys (exit polls), and routine data from NHIS, vital registration, etc [48]. |
5.2 Vertical equity | Â |
5.3 Fairness in financial contribution | Â |
6.1 Allocative efficiency | National NHIS: (i) health facility service data, e.g. numbers of curative and preventive outpatient visits, numbers of hospital admissions and discharges, numbers of hospital deaths, numbers of diagnostic services, volume of community-based health services; (ii) quantities and values of resources, e.g. supplies, health workforce, finances, infrastructure. If data is not available centrally, there may be need to collect it from health facilities, using existing questionnaires [63, 64]. |
6.2 Technical efficiency | Â |
6.3 Productivity growth | Â |
6.4 Institutionalization of efficiency monitoring | Â |
7.1 Existence of transparent results-oriented reporting and assessment frameworks | This data should be obtained simultaneously with that in 4.5-4.9. |
7.2 Diagnostic reviews | Â |
7.3 Use of information from diagnostic reviews | Â |
7.4 Publishing of audit reports for public consumption | Â |
8.1 National health research systems (HRS) | Review existing Health Research Systems Analysis (HRSA) reports; and where non existent conduct an assessment of HRS using HRSA toolkit [65]. |
8.2 Health knowledge management systems (HKMS) | Review existing HKMS reports; and where they do not exist undertake an assessment of HKMS using "Research Matters" Knowledge Translation Toolkit [68]. |
8.3 Health management information systems | Review existing NHIS reports; and where non-existent conduct an assessment using Health Metrics Network tool [69]. |
8.4 Information, Communication and Technology Connectivity | Include relevant questions in the survey questionnaire mentioned in 1.4. |
9.1 International ethical guidelines for medical practice and health research | This data should be collected simultaneously with that in 8.1 using same methods and tools. |
9.2 Bioethics review system | Â |
9.4 Institutionalization of ethics training | Â |
10.1 Link between NEDP, PRSP and NHP/NHSP | Review of the NEDP, PRSP, NHP and NHSP |
10.2 Existence of a MTEF | Review of MTEF document complemented with in-depth interviews with Ministry of Finance and Ministry of Health. |
10.3 Political stability | Review of the national constitution, in-depth interview with chairperson of national legal bar association, and reference to both the Economist Intelligence Unit Democracy Index [40] and the Ibrahim Index [41]. |