[Health system governance challenges and lessons from COVID-19 for Colombia].

Objective: To determine the quality of governance of the Colombian health system and to analyze the lessons brought by the covid-19 pandemic, considering the perception of leaders who are part of the system.

Material and methods: Descriptive and exploratory study based on survey data, whose sample was non-probabilistic for convenience. 107 health system leaders participated. The data were analyzed considering a health systems performance evaluation framework.

Results: Survey participants rated health system governance an average of 2.6/5.0, corresponding to low quality of governance. Despite the poor rating, leaders perceived improvements during the pandemic in the performance of purposes such as strategic vision and system supervision, and regarding they considered improvements in capabilities of risk management and information management.

Discussion: This study provides an approach to the governance of the system, considering the subfunctions proposed in the evaluation framework, which constitutes an opportunity to know the failures and aspects that must be improved, even more, after going through the pressures of the covid-19. The system must learn from these aspects to be prepared for the next external shock. The research offers an outlook for new studies that can use the same framework and propose governance indicators to evaluate and monitor it.