METHODOLOGICAL APPROACHES TO HEALTH SYSTEMS GOVERNANCE RESEARCH

Abstract

Background: Governance in health is a process whereby important decisions are made and determining who is accountable. Good health system governance (HSG) can ensure optimal functioning of the health system influenced by transparent rules and governed by effective oversight. Assessment of governance can influence the health outcome of the population when subsequent improvement is made for better policy input. The aim of this review is to understand the methodological research approaches used in the assessment of HSG. Methodology: A review was directed from a collection of articles obtained from Pubmed, ScienceDirect and CINAHL databases that summarises relevant prior publication on methodological approaches that have been used in HSG research describing study design, methods of data collection and analysis. Only original articles of the past ten years (2009 to 2019) published in English language is included. Data was extracted base on a pre-constructed matrix. Results and Discussion: Findings revealed different research methods for the qualitative, quantitative and mixed-methods design. Similarities between the three are in terms of how research questions direct the choice of study design and the use of a governance framework or recommendation of indictors to guide the study.  There were differences in terms of the nature of study, the methods used, and type of information gathered. Each study design has its own strengths and limitations. Lessons learned include research going beyond descriptions, tailoring approaches to fit study objectives, the importance of communicating findings and being clear in giving recommendations for policymaking. Conclusion: The qualitative design is contextual yet difficult to generalize, the quantitative design is generalizable yet very explicit to certain indicators specified while the mixed methods design is comprehensive but requires more resources to carry out. Keywords: health system governance, assessment, methodological approaches, research design