Health Systems Strengthening through Good Governance: A RESEARCH PRIORITY SETTING WORKSHOP
1
Health Systems Research Unit, South African Medical Research Council, Parow, Cape Town, South Africa
2
The George Institute of Global Health, New South Wales, Australia
3
Office of AIDS and TB Research, South African Medical Research Council, Cape Town, South Africa
4
School of Public Health, University of Western Cape, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1852
ABSTRACT
INTRODUCTION:
South Africa (SA) is undertaking several reforms to attain universal health coverage (UHC). Effective governance is recognised as a key pillar of a strong health system. Ongoing health system governance issues jeopardise the realisation of UHC. Therefore, identifying which tested strategies address health system governance issues and which may be relevant for SA is critical.
METHODS:
Researchers from the South African Medical Research Council (SAMRC) and The George Institute of Global Health (TGI) organised a priority-setting workshop to identify, conceptualise, and prioritise strategies to develop research questions for addressing health system governance challenges in SA. Over 40 representatives from government, civil society, academia and the healthcare sector were invited to a one-day workshop hosted in Cape Town in August 2025. Activities included a panel discussion in which representatives from interest-holders shared their experiences with health system governance. This was followed by academic presentations on current local and global evidence regarding the strategies and challenges of health systems governance, as well as a civil society presentation on the legal case concerning local health systems governance, specifically national health insurance. Thereafter, a World Café session took place, where attendees discussed the challenges and strategies across the six domains of the WHO health systems building blocks. Finally, participants prioritised the strategies to be further researched within the context of the SA health system.
RESULTS:
Multiple strategies emerged across health system domains. These included strengthening leadership across all levels of the health system, improving financial transparency, planning of a long-term responsive workforce informed by population needs, the importance of community-engagement in healthcare benefits and service design decision-making, and the integration of digital tools across the health system guided by system-thinking approaches,
CONCLUSIONS:
The workshop highlighted strategies to be further evaluated to progress towards effective governance of the SA health system.
South Africa (SA) is undertaking several reforms to attain universal health coverage (UHC). Effective governance is recognised as a key pillar of a strong health system. Ongoing health system governance issues jeopardise the realisation of UHC. Therefore, identifying which tested strategies address health system governance issues and which may be relevant for SA is critical.
METHODS:
Researchers from the South African Medical Research Council (SAMRC) and The George Institute of Global Health (TGI) organised a priority-setting workshop to identify, conceptualise, and prioritise strategies to develop research questions for addressing health system governance challenges in SA. Over 40 representatives from government, civil society, academia and the healthcare sector were invited to a one-day workshop hosted in Cape Town in August 2025. Activities included a panel discussion in which representatives from interest-holders shared their experiences with health system governance. This was followed by academic presentations on current local and global evidence regarding the strategies and challenges of health systems governance, as well as a civil society presentation on the legal case concerning local health systems governance, specifically national health insurance. Thereafter, a World Café session took place, where attendees discussed the challenges and strategies across the six domains of the WHO health systems building blocks. Finally, participants prioritised the strategies to be further researched within the context of the SA health system.
RESULTS:
Multiple strategies emerged across health system domains. These included strengthening leadership across all levels of the health system, improving financial transparency, planning of a long-term responsive workforce informed by population needs, the importance of community-engagement in healthcare benefits and service design decision-making, and the integration of digital tools across the health system guided by system-thinking approaches,
CONCLUSIONS:
The workshop highlighted strategies to be further evaluated to progress towards effective governance of the SA health system.
| eISSN: | 2654-1459 |
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