1. Capacity Development Workshop on Health System Development for National Policy-makers & WHO Staff Health Systems Governance Group Work Group 1

2. Q1: What are the strengths and weaknesses of health system governance in the Republic of Emrovia? Governance PrincipleCentral LevelMOH Policy Level MOH Implementation Level Strategic Vision Participation and consensus orientation Rule of law Transparency Responsiveness Equity and inclusiveness Effectiveness and efficiency Accountability Intelligence and information Ethics StrengthWeakness

3. Q2: What are the priority problems in health system governance and what are the potential strategies to address these issues? “ Weak or Absent systems for implementation and accountability” Problem : Gathering and use of information Solution : 1.Assess health information systems to identify gaps 2.Develop strategy for health information including establishing health observatory Problem : Lack of/outdated regulations Solution : 1.Review/Revise systematically including development of performance standards 2.Promote advocacy by non government actors Problem : Weak enforcement of regulations Solution: 1.Social mobilization and awareness 2.Enhancing mechanisms for monitoring and transparency including establishment of institutional incentives and sanctions

4. Q3 : Governance is a sensitive issue and poses several bottlenecks, what are the potential risks in tackling them? Loss of position by champions Parliamentary opposition Inter-sectoral collaboration breakdown/resistance Conflict of interest with opposition by corrupt parties Failure of reforms due to lack of expertise in information/analysis Financing not forthcoming to implement intended reforms Reforms derailed by larger forces e.g. war/insurgence