Governance is the systematic, patterned way in which decisions are made and implemented. The governance of a health system therefore shapes its ability to respond to the various well- documented challenges that health systems face today, and its capacity to cope with both everyday challenges and new policies and problems.

This book provides a robust framework that identifies five key aspects of governance, distilled from a large body of literature, that are important in explaining the ability of health systems to provide accessible, high-quality, sustainable health. These five aspects are transparency, accountability, participation, organizational integrity and policy capacity. Part 1 of this book explains the significance of this framework, drawing out strategies for health policy success and lessons for more effective governance. Part 2 then turns to explore eight case studies in a number of different European regions applying the framework to a range of themes including communicable diseases, public–private partnerships, governing competitive insurance market reform, the role of governance in the pharmaceutical sector, and many more.

The book explores how:

• Transparency, accountability, participation, integrity and capacity are key aspects of health governance and shape decision making and implementation;

• there is no simply “good” governance that can work everywhere; every aspect of governance involves costs and benefits, context is crucial; 

• governance can explain policy success and failure, so it should be analysed and in some cases changed as part of policy formation and preparation; and 

• some policies simply exceed the governance capacity of their systems and should be avoided.

  This book is designed for health policy-makers and all those working or studying in the areas of public health, health research or health economics.