A Conceptual Approach to Governance

1
A Conceptual Approach to Governance Equity in
Health Systems Research

• A. Arredondo E. Orozco - INSP (Mexico)
• E. Bascolo - LAZARTE (Argentina)
• R. Bazzani - IDRC / GEH
• M. Hufty - IUED (Switzerland)
• F. Yepes D. Guarin - ASSALUD (Colombia)

2
The problem

• Lack of conceptual coherence(evidenced by a
  litterature review and a survey of researchers
  and decision makers)
• Diverse understanding of "governance" in LAC GEH
  projects
• Different and contradictory use of governance
  among researchers
• Confusion between governance and governability
  among researchers and decision makers
• A recent term in Spanish
• "Governance" is unknown among non-researchers in
  LAC
• Hence, there is a need for building a common
  analytical approach on governance in health
  research

3
Expected Results

• Consensus
• To generate consensus among a group of GEH
  projects regarding the use of a governance
  conceptual approach
• Toolkit
• To develop a conceptual / analytical framework
• Working Paper
• To write a working paper in order to promote a
  wider discussion with other audiences
• Partnerships
• To promote partnerships and networking to test
  and refine this approach

4
Research and advocacy

• Research
• Based on a theoretical framework
• Objective to know society
• Methodology  to analyse facts (values are
  controlled through empirical testing)
• Actors, norms and rules, processes and nodal
  points are studied
• Expected results 
• Increased knowledge on society

• Advocacy
• Based on a set of values
• Objective to change society
• Methodology  to change facts in order to conform
  them to one's values
• Actors, norms and rules, processes and nodal
  points are changed
• Expected results 
• Society is better

5
Action - Research

• Research
• Increased knowledge on society

• Advocacy
• Society is better

Researchers
Advocacy groups
Policy-makers
Communities
6
The Equity Outcome
7
Governance (Failure)
Equity (Failure)
Solution
Governance 1. Nodal points 2. Actors 3. Norms 4.
Processes

Resolution
Nodal point A
B
B
Intervention
C
D
8
Working Paper

• Objectives
• to build a conceptual approach
• to disseminate the proposed approach
• Methodology
• Common understanding (Montevideo, Oct. 04)
• Exchange of papers (Nov. 04 - March 05)
• Group session (GEH Saly April 05)
• Integration of contributions (May-June 05)
• Publication in 3 languages (July - sept. 05)

9
Next Steps

• Discussion with other audiences based on the
  Working Paper
• Further methodological development
• Partnership and networking
• Testing and validation of the analytical
  framework and toolkit through case studies