Health governance capacity—defined as “the ability of a nation’s institutions to implement health policies, provide medical services, allocate resources efficiently, and help countries respond to global health crises”—plays a pivotal role in ensuring positive health outcomes of populations. According to a new Brookings report, Health Governance Capacity: Enhancing Private Sector Investment in Global Health, it is also an important factor in attracting and leveraging private sector investment to further strengthen health systems and promote research and development.
As countries strive to attract more private investment to their health care systems, they must consider the following question: What policy, regulatory, and legal reforms will create an environment conducive to greater investment in health?
To unpack this question, the report examines the quality of health care governance in 18 low- and middle-income countries in sub-Saharan Africa and Asia along five dimensions: health management capacity, health policies, health regulations, health infrastructure and financing, and health systems. Using data on 25 indicators related to these dimensions, the study finds that the factors that can enable greater private sector investment in public health are: “improving transparency, strengthening management capacity, lowering tariffs on incoming medical products to the extent that is fiscally possible, expediting regulatory reviews of new drugs, building effective health infrastructure, and increasing appropriately-targeted and efficient public spending on healthcare.”
The study also constructs an index using the 25 indicators, called the Health Governance Capacity Index, that reflects an overall health governance score for each of the countries and allows them to be ranked based on their attractiveness and readiness for greater private sector investment (see Figure 1). Of the 18 countries in the study, Vietnam, South Africa, China, and Ghana received the highest overall scores for health governance capacity. Notably, several African countries also have certain strengths that are conducive to greater investment. For instance, Ghana and Liberia scored highest of all countries in terms of their management capacity; Tanzania’s health policies were ranked best overall; South Africa’s and Uganda’s health regulations scored highest; and South Africa’s health infrastructure was ranked best (alongside China’s). African countries with weaker performances on the index include the Democratic Republic of the Congo and Nigeria.