EPHO6: Assuring governance for health and wellbeing
The purpose of this essential public health operation (EPHO) is to ensure that public health services are well governed through efficient methods, processes and institutions which maintain accountability, quality and equity. The process which informs decision-makers on issues related to public health is known as policy development. It is a strategic planning process that involves all internal and external stakeholders and defines the vision, mission, measurable health goals and public health activities at national, regional and local levels.
A recent self-assessment of public health services in 41 of the 53 countries in the WHO European Region found that:
- Most countries in the WHO European Region report clear accountabilities at the governmental level for ‘traditional’ public health functions such as communicable disease control and sanitation.
- There are positive examples of innovative intersectoral structures promoting ‘Health in all’ approaches. For instance, environmental health and mental health are the most common areas for intersectoral collaboration.
- However, intersectoral approaches and accountability are often poorly defined for health improvement and promotion across the Region; many programmes are still delivered in a vertical structure.
As a result, a recommendation was made to strengthen governance mechanisms for public health by establishing cross–sector governmental committees, by appointing a minister of public health, by establishing clear lines of reporting and accountability, by monitoring performance management systems for transparency of decision-making, and by implementing information sharing, consultation and participation.
Strengthening sub-national governance – Regions for Health Network
Various regions within Europe have joined together for a health network to address social determinants of health and health inequities. WHO/Europe is currently re-launching its Regions for Health Network to accelerate action on social determinants of health at regional level; for instance, through sharing of experiences and joint interventions.
Public health governance
In its strategy to promote good governance in health, WHO/Europe guides governments towards system-wide, evidence-based approaches through facilitating links and partnerships between stakeholders, and promoting the inclusion of health in all policies.
Strengthening local-level governance – WHO Healthy Cities Project
This project seeks to place health high on the agenda of decision-makers in cities and to mobilize action for health and health equity in local policies. The WHO/Europe launched the European Healthy Cities Network in 1987 as a vehicle to bring a “health for all” strategy to the local level.
Intersectoral governance for health in all policies
WHO/Europe provides support in understanding of the process that leads to health components in policies. It recognizes the need to evaluate the effectiveness of different governance structures in producing action on social determinants of health. It is a practical resource to enable intersectoral policy action with the aim to work towards the goals outlined in the Health 2020 policy framework.
Health care quality
WHO/Europe supports countries in improving the quality of health care. Current research is designed to enhance the role of the patient in reducing safety risks within three priority themes of blood transfusion, hospital infections and hand hygiene. In addition, a fourth theme is to improve communication during patient handovers.
Health technologies and pharmaceuticals
WHO/Europe provides direct technical support to countries in order to strengthen regulatory systems and improve access to medicines. The programme focuses mostly on countries where public access to essential medicines and medical devices is limited.
