a Jockey Club School of Public Health and Primary Care , The Chinese University of Hong Kong , Hong Kong , China.
b Our Hong Kong Foundation , Hong Kong , China.
Health Syst Reform. 2019;5(1):48-58. doi: 10.1080/23288604.2018.1543521.
Many countries in the Asia-Pacific region have committed to universal health coverage (UHC), which is reflected in both their political commitment and the governance actions they have taken in steering their health systems toward the goals of universal access to care and protection from financial hardship. Countries throughout the region are at different stages of development and have different political and governance contexts, which in turn shape how they pursue governance for UHC. This article reviews the governance functions deployed in the Asia-Pacific and finds that, in many, governance reforms adapting their health systems toward greater regulation, accountability, oversight, and stewardship of the health system have been part of their wider move toward UHC. Countries have not followed a set pattern, but shared aspects include establishing UHC as a goal in national policy making and priority setting; the creation of new roles and/or new institutions within the health system; establishing systems of monitoring and evaluation; and putting in place mechanisms to facilitate collaboration and ensure greater accountability. The relationship between governance and UHC in the Asia-Pacific region is found to be complex, negotiated, and shaped by a number of factors in both the internal and external environment, including broader governance arrangements in the public sector (institutional changes and decentralization are particularly prominent factors) and the ability of governments to implement policies and steer the health system.
许多亚太国家都致力于全民健康覆盖（UHC），这体现在他们的政治承诺和为实现全民获得医疗服务和免受经济困难影响的目标而对卫生系统进行治理的行动中。该地区各国处于不同的发展阶段，具有不同的政治和治理背景，这反过来又影响了他们追求 UHC 治理的方式。本文回顾了亚太地区的治理职能，并发现，在许多情况下，使卫生系统更加规范、问责、监督和管理的治理改革，是其朝着 UHC 迈进的更广泛举措的一部分。各国并没有遵循一套固定模式，但共同的方面包括将 UHC 确立为国家政策制定和优先事项的目标；在卫生系统内建立新的角色和/或新机构；建立监测和评价系统；以及建立促进协作和确保更大问责制的机制。在亚太地区，治理与 UHC 之间的关系被发现是复杂的、协商的，并受到内部和外部环境中许多因素的影响，包括公共部门更广泛的治理安排（机构变革和权力下放是特别突出的因素）以及政府实施政策和引导卫生系统的能力。
