Health system stewardship of National Health Ministries in the WHO European region: Concepts, functions and assessment framework
Health system stewardship of National Health Ministries in the WHO European region: Concepts, functions and assessment framework
复制标题
DOI：
10.1016/j.healthpol.2011.09.002
复制
发表时间：
2011-12-01
期刊：
影响因子：
3.3
通讯作者：
Klazinga, Niek Sebastian
中科院分区：
文献类型：
--
作者：
Veillard, Jeremy Henri Maurice;Brown, Adalsteinn Davidson;Klazinga, Niek Sebastian
目的：提出一个业务框架，评估的完整性和一致性的管理职能的国家卫生部委。方法：作者进行了有目的的和多学科的文献回顾，并得出一个业务框架，通过迭代讨论和参与式的方法。文献回顾的结果进行了比较，作者的意见，在行动中的管理和关键职能匹配的情况下，从欧洲和北美的例子。结果：业务框架涉及六个职能的管理与国家的背景下，价值观和最终目标所追求的卫生系统：确定远景的健康和战略，以实现更好的健康;对所有部门施加影响，以增进健康;以符合普遍价值观的方式管理卫生系统;确保系统设计符合卫生系统目标;更好地利用现有的法律的和监管文书;汇编、传播和应用情报。实施管理方面的挑战涉及：卫生部作用的局限性;以及治理、运营和变革实施问题。拟议的框架似乎足够灵活，可以帮助评估卫生系统的管理职能;但是，还需要在实践中进一步检验。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。
Objectives: To propose an operational framework for assessing the completeness and consistency of the stewardship function of national health ministries.Methods: The authors carried out a purposive and multidisciplinary review of the literature and derived an operational framework through iterative discussions and participatory methods. The results of the literature review were compared to the authors' observations of stewardship in action and key functions were matched with case examples from Europe and North America.Results: The operational framework relates six functions of stewardship with national contexts, values and ultimate goals pursued by health systems: to define the vision for health and strategy to achieve better health; to exert influence across all sectors for better health; to govern the health system in a way that is consistent with prevailing values; to ensure that system design is aligned with health system goals; to better leverage available legal and regulatory instruments; and to compile, disseminate and apply intelligence.Conclusions: Challenges in the implementation of stewardship relate to: limitations to the role of health ministries; and to governance, operational and change implementation issues. The framework proposed seems flexible enough to help assess the health system stewardship function; however it should be further tested in practice. (C) 2011 Elsevier Ireland Ltd. All rights reserved.