STEWARDSHIP AND GOVERNANCE OF PUBLIC HEALTH POLICIES |
GOVERNANCE, GOVERNABILITY AND GOOD GOVERNANCE |
Knowledge and scope of the term stewardship |
Incorporation of the social perspective into the other functions and roles |
Normative and traditional health services provision function |
Compliance with Rules, Regulations and Laws |
Strict conduction methods coexist, adherence to rigorous standards, decreases integration of new stakeholders, paralyzes work teams, alienates organizations and fragments the provision of services. |
Reinterpretation of the stewardship concept |
Adds social cohesion and aligns government and development policies |
Overcomes bureaucratic barriers, facilitates structuring between upper and lower levels |
Incorporates adjustments and adaptations into changes and organizational innovations |
The governing role should broaden its scope, incorporate organizational innovations, adaptability, agility, leadership, specialization, it should promote governance, exercise the role of organizing and articulating of stakeholders, institutions and organizations. |
Mechanisms for the selection of government officials |
Trust positions, transfer of experts from other government secretaries |
They do not respond to merits, some managers remain |
Global rotation of HR, managers and technicians from all health authorities |
Only in some cases, the HR profile is characterized by aptitude, suitability, leadership, training, skills and conduction abilities. |
Existence of management assessment tools |
They are evaluated by management results and the Executive evaluates the ministers. |
There are no tools to assess skills and abilities of managers, but rather of middle managers |
Popularity level is measured as a synonym of management acceptance |
In general, they are evaluated by the results of management, through opinion surveys to the public (successful processes, cohesion of executives). |
Level of consensus achieved |
High |
Median |
Low |
Balance of authority, legitimacy of values and social norms. |
Model (Political conduct) |
Synergic model |
Mixed |
Hierarchical model |
Trust-based cooperation is more effective than authority-based cooperation. |
Participation of a diversity of stakeholders: Intersectoriality |
Mixed decisional networks |
Median |
Weak |
Multiple mechanisms and initiatives for the direct participation of society and communities in the management of public policies. |
Perception of society and governability |
Balance of authority, legitimacy of values and social norms |
Transition, tendency to centralization |
Centralized, bureaucratic management |
Good governance: Mission to guide, within the framework of a comprehensive and sustainable development, the primary goals and objectives of health, quality of life and well-being. |
Planning and Implementation of Policies |
Strengthening strategic stakeholders vs Weak evaluative processes |
Insufficient political and technical times. |
Institutional Strategic Plan |
Planning must incorporate the rights, values and practices approach, as a support for the regulatory framework designed to implement the policies. |
Financial Management, quality of expenditure, efficiency, central government / subnational levels coordination |
Free services |
Management evaluation similar to the rest of the programs |
Rotation of qualified stakeholders that affected the institutionality |
Changes in care and organizational models are restricted due to lack of financial guarantees. |