School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Int J Equity Health. 2017 Sep 15;16(1):171. doi: 10.1186/s12939-017-0665-0.
The unifying theme of the papers in this series is a concern for understanding the everyday practice of governance in low- and middle-income country (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 multi-disciplinary 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.
本系列论文的统一主题是关注理解中低收入国家(LMIC)卫生系统治理的日常实践。这些论文并没有将治理视为通过问责制和监管框架的构建和设计来实现的规范性卫生系统目标,而是深入了解卫生政策和系统行为者的实际决策。他们的多项日常决策将政策意图转化为实践——并通过关系进行过滤,这些关系以价值观和规范为基础,受到组织结构和资源的影响,并嵌入历史和社会政治背景中。这些决策也是政治行为——因为它们影响谁能获得利益,以及谁的声音在决策中被听到,从而加强或挑战现有的制度排斥和权力不平等。换句话说,治理的日常实践对卫生系统公平性有着直接的影响。本系列论文通过多样化的卫生政策和系统问题探讨治理问题,考虑了位于系统多个层面的行为者,并借鉴了多学科视角。这些论文详细考察了在一系列非洲和印度背景下的经验,由在这些背景下生活和工作的作者主导。因此,本系列论文的总体目的是提供关于卫生系统治理和公平性的实证和嵌入研究视角。