From frameworks to practices: experiences of sub-national governance in low and middle-income countries

Register now for a free interactive session on 23 February 2018, 1:00pm GMT.

09 February 2018

The health systems governance collaborative - in conjunction with RESYST and CHESAI consortia - are hosting a webinar drawing on a recent special series on health system governance in the International Journal for Equity in Health. The unifying theme of the papers in this series is a concern for understanding the everyday practice of governance in low- and middle-income country health systems.

The webinar will focus on two case studies of sub-national governance in the series - devolution in Kenya and implementation of policies shaping provider-patient interaction in two South African hospitals. Through these cases the webinar will draw attention to: 

  • Governance as distributed within health systems, and not just the property of national spheres
  • Influences on sub-national governance, and the complex interplay of hardware and software
  • The notion of ‘everyday governance’ and its role in illuminating the decision-making processes that are central to governance concerns
  • The role of embedded research in documenting the ‘hidden dynamics’ of governance within health systems 

Rather than seeing governance as a normative health system goal addressed through the architecture and design of accountability and regulatory frameworks, these papers provide insights into the real-world decision-making of health policy and system actors. Their multiple, routine decisions translate policy intentions into practice – and are filtered through relationships, underpinned by values and norms, influenced by organizational structures and resources, and embedded in historical and socio-political contexts.


This webinar will last for 75 minutes. Opening and concluding remarks will be given by Maryam Bigdeli and the webinar will be moderated by Helen Schneider. It will be divided into the following three sections:

  1. Brief Overview: Lucy Gilson will give a brief overview of the series and the approach to thinking about governance. [05 minutes]
  2. Introduction of Case Studies: Benjamin Tsofa and Ermin Erasmus will briefly introduce their respective case studies and what they each reveal on the themes. [20 minutes]
  3. Open Discussion: We will invite all contributors to come forward and share insights and experiences on the practices of sub-national governance and the implications for conceptual frameworks, capacity strengthening and research on health system governance. [50 minutes] 

The slides from the presentations will be in English and will be accessible online afterwards. Policymakers, researchers, and all other stakeholders are invited to attend. Register now.