By Siswanto Agus Wilopo
Department of Public Health, Faculty of Medicine, Gadjah Mada University
Abstract
Health is a basic human right, and must be available and accessible to all peoples in an affordable framework. Promoting good governance and fairness in the health sector through meaningful and consistent emphasis on prompt delivery, equitable and professional services, transparency and accountability must become a cardinal principle of the health sector reform. The question is: what is internationally adopted paradigm of good governance in health system and development? How should we conduct health sector reform, especially in health system to be consistent with the international dimension of good governance? This paper examines at factual evidence to describe the main challenges facing health system in developing countries, especially in Indonesia.
In this article we also present the main issue and critical factors that facilitate to health sector reform following the process of good governance, especially based on the international dimension. The governance refers to the exercise of economic, political and administrative authority to manage a countries affairs at all levels. It comprises mechanisms, processes, and institutions, through which citizens and groups articulate their interests, exercise their legal rights, meet their obligations and mediate their differences. Health system is all the activities whose primary purpose is to promote, restore or maintain health. We address the context and framework under which health systems function under good governance at the national and local levels. We argued that first and foremost is better accountability of government services. Second, an incentive that raises performance is an importance element of the health system reform. Third, where public health services are free or subsidized, especially for the poor, the abuses related to lack of drugs, staff absences and informal payments undermine these objectives as well as the credibility and effectiveness of public services more generally.
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