Zhao Xuan, Yuan Beibei, Yu Yahang, Jian Weiyan
1China Center for Health Development Studies, Peking University, Beijing, China.
2School of Public Health, Peking University, Beijing, China.
Glob Health Res Policy. 2019 Nov 18;4:34. doi: 10.1186/s41256-019-0126-y. eCollection 2019.
Health system governance is critical to the operation of a country's health system and its overall performance. This study analyzes the role of health system governance in driving health policy innovation and effective implementation.
A retrospective review is applied to collect, analyze and synthesize information from publications and policy documents relevant to the implementation of a typical health policy, the Patriotic Health Movement.
The analysis of governance highlighted a number of features underpinning this policy. These included highest authority prioritizing health system development, specific health policies being prioritized within the national development agenda, strong political will to promote the policies drawing on the advantages of the highly hierarchal administrative system in China, and accumulating evidence from local experience to support policy making It was also found that the formation of these governance practices and how they drove policy innovation and implementation were both closely related to the political and socio-economic contexts in China.
Given that many low- and middle- income countries are strengthening their health systems aimed at UHC, this study demonstrates that along with drawing lessons from health policies or interventions, addressing factors in each governance domain is critical in adapting the policy design to other settings and the effective operation of policies in other settings.
卫生系统治理对于一个国家卫生系统的运作及其整体绩效至关重要。本研究分析了卫生系统治理在推动卫生政策创新和有效实施方面的作用。
采用回顾性研究方法，从与一项典型卫生政策——爱国卫生运动实施相关的出版物和政策文件中收集、分析和综合信息。
治理分析突出了支撑该政策的若干特征。这些特征包括最高权威将卫生系统发展列为优先事项、特定卫生政策在国家发展议程中被列为优先事项、利用中国高度层级化行政系统的优势推动政策的强烈政治意愿，以及积累地方经验证据以支持政策制定。研究还发现，这些治理实践的形成及其推动政策创新和实施的方式均与中国的政治和社会经济背景密切相关。
鉴于许多低收入和中等收入国家正在加强其旨在实现全民健康覆盖的卫生系统，本研究表明，除了借鉴卫生政策或干预措施的经验教训外，解决每个治理领域的因素对于使政策设计适应其他环境以及政策在其他环境中的有效运作至关重要。
