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This Chapter provides health policymakers, managers, and care providers with an overview of strategies that enforce the key principles of good governance presented in Chapter 4. Strengthening participatory governance, building policy capacity, institutionalizing procedures to incorporate evidence in policymaking, and building regulatory capacity are critical for strengthening participation, transparency, and accountability and enforcing the rule of law. There is a variety of potential strategies that health system managers can adapt to improve governance of health systems at the policy, institutional, and healthcare professional levels, these include: (1) strengthening effectiveness of decentralization at the policy level; (2) linking accreditation to incentives, such as public funding or contractual agreements, at the institutional level; and (3) professionally led self-regulation at the health care professionals’ level. Control of corruption requires political reforms with a focus on open exchange of information, channels for participation of citizens in policymaking, and penalties for the misuse of power. It is important to note that the evidence on governance strategies in L&MICs remains elusive. Health leaders and managers need to cautiously assess and adapt strategies to their own contexts.
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