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Governance & Health

Effective governance is key to achieving sustainable improvements in public health. KIT’s advisors in this field support governments, civil society organisations, private sector and NGOs in their efforts to improve health sector governance.

Governance in this context refers to the formal and informal processes of interaction and decision-making that determine the sustainability of the health system and the equity of health services and outcomes.

Institutional Quality and Accountability Mechanisms

Due to widespread poverty and inequality and a lack of resources, sustainable and equitable development will remain elusive unless attention is given to building strong institutions and accountability mechanisms within health systems.

KIT is involved in initiatives to improve the accountability relations within health systems through supply-side measures, for example through results-based financing and incentive based systems, quality improvement programmes, contracting, supervision and training.

Over the past few years, demand-side accountability has gained ground in the health sector. By this we refer to processes or interventions whereby individuals and groups of citizens voice their concerns, demand explanations and accountability, and impose sanctions on poor performance. From KIT’s and from a human rights perspective, both demand-side and supply-side mechanisms of accountability need to be strengthened to enhance performance of health services to ensure sustainable and equitable health systems in the long term.


KIT provides support by assessing the governance, sustainability and equity dimensions of policy making and service delivery. We do so by combining the expertise of advisers with diverse and complementary backgrounds in health system development, gender and rights, governance and rural development.

The Millennium Development Goals have improved the lives of millions but sustainable progress can only be achieved through inclusive and effective governance.
African post-2015 dialogue, October 2012

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Related Projects

  • Human Resources for Health in Conflict Affected Settings: A Scoping Review of primary peer reviewed publications 2016 – 2022

    • Institute
    • Publication

    Conflict has devastating effects on health systems, especially on healthcare workers (HCWs) working in under-resourced and hostile environments. However, little evidence is available on how policy-makers, often together with development partners, can optimize the organization of the health workforce and support HCWs to deliver accessible and trustworthy health services in conflict-affected settings (CAS). A scoping […]

  • Addressing Governance, Gender and Disasters in a Fragile Health System

    • Institute
    • Project

    This two-week tailor-made training  course was designed to provide staff at the Aga Khan University, Karachi (AKU) with both theory and practical tools for governance and gender mainstreaming within health systems, particularly with respect emergency response. Redressing the balance in an ill-prepared health system Pakistan is regularly confronted with natural disasters as well as conflict. As gender inequality […]

  • Strengthening HRH Planning and Management in Moldova

    • Institute
    • Project

    Moldova faces an enormous emigration of health professionals especially to the EU and US. The Moldovan Ministry of Health and the Observatory for Human Resources for Health (HRH) therefore approached KIT to help them improve human resource management skills in order to motivate health workers to remain in Moldova. Training to Remain KIT examined the […]

Our Expert

Our advisors work in both Anglophone and Francophone countries, in both stable and fragile states.

Strengthening Health Systems topics


KIT MAG: an annual magazine packed with stories about our activities, at our campus in Amsterdam and with partners worldwide.

Browse the magazine online or take a copy with you when you visit KIT (at the reception).