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Assuring effective health governance, public health legislation, financing and institutional support

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Operational definition

Governance

Governance includes evidence-based policy development that informs decision-making on issues related to public health by upholding the key governance principles of fairness, accountability, transparency and participation. The subsequent strategic planning process should operationally define the vision, mission, measurable health goals and public health activities for national, regional and local levels. Moreover, it has become more important to assess the implication of international health developments on national health status.

Public health legislation

Public health legislation includes the institutional capacity to formulate health legislation, especially public health laws and regulations that enable actions to prevent disease, and protect and promote public health by ensuring proper, consistent and timely compliance with the regulatory and enforcement frameworks.

Institutional support

Institutional support implies ensuring that effective organizational structures and mechanisms are in place to ensure effective delivery of health promotion, disease prevention and health protection interventions. 

Financing and resource allocation

Financing and resource allocation is concerned with the collection, pooling, allocation of resources, purchasing and procurement mechanisms to cover population health needs. This also includes innovative financing mechanisms like sin-tax, airline ticket tax, and Tobin tax. Comprehensive public financing should be the norm for proven cost-effective population-based as well as personal services with broad effects beyond the person [externalities] receiving the intervention. 

Scope of the function

Governance

  • National government commitment to health and health equity as an explicit priority in national policy

Participatory healthy public policy based on health in all policies (HiAPs) concept

  • National strategies, policies and plans for public health 

Cross-sectoral planning process

Consideration of international health developments

Definition of responsibilities for implementation

Structural, process and outcome indicators linked to time-based targets

  • Quality assurance schemes
  • System for monitoring and periodic evaluation of effectiveness

Public health legislation

  • Capacity for developing and implementing the appropriate national legislation to improve public health and promotion of healthy environments, aligned with regional and global commitments  
  • Effective structures, resources and processes for enforcement of public health and health-in-all-policies legislation and regulations.
  • Adoption of transparent audit and accountability mechanisms across planning and implementation processes.

Institutional support

  • Build institutional capacity and skills that enable the implementation of health-in-all-policies by adopting a multi-sectoral approach
  • Create or support institutional structures or platforms for the appropriate implementation of key public health functions (e.g. National public health institutes, health protection agencies, centres for diseases control and prevention or other structural mechanisms).

Financing and resource allocation

  • Existence of budget lines for both systematic and emergency public health services
  • Allocation of resources based on principles of equity and cost-effectiveness
  • Purchasing and procurement mechanisms linked to public health planning.

Assessment of essential public health functions in countries of the Eastern Mediterranean Region