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The Eastern Mediterranean Region: Pioneering innovative solutions for health systems’ actionable governance

At the beginning of November, a group of policy-makers, experts and health practitioners convened in Beirut, Lebanon, to exchange on the Eastern Mediterranean region’s governance challenges, and to launch the first Regional chapter of the Health Systems Governance Collaborative. Countries in the Region have been grappling with health system governance challenges such as various shocks to the health system e.g. natural disasters, economic crises, conflicts and refugee flows, etc.; the fragmentation of the health sector posing challenges to steer & implement policies and transform governance; and institutional arrangements & governance functions which are frequently inflexible and/or not adapted to the highly dynamic context.

The regional level is actually ideally placed to act as a platform for exchange as countries share some commonalities shaping their respective health systems, alongside unique characteristics in terms of pathways of change. Moreover, a regional perspective allows for exchange and mutual learning, developing collective intelligence on cross-border challenges affecting health systems.

The countries of the Region have taken the lead in exploring and adopting innovative governance solutions, with a view to achieving UHC and other challenges,  such as: the “dialogue sociétal” in Tunisia,  accountability and coordination in Sudan, clinical governance and hospital management in Egypt, intersectoral action to achieve UHC in Iran, devolution following the 18th Amendment in Pakistan, the “régionalisation avancée” in Morocco, emergency preparedness and response in Oman…

The Regional Collaborative shares a common vision on health system governance, starting from the complex and dynamic nature of the health system. Challenges facing the health system in the EMR call for a) a focus on ‘actionable governance’ to promote dialogue and inclusiveness and b) exploring progressive ‘best-fit’ approaches to health system governance, adapted to the context to address barriers and look into opportunities to expand UHC in the EMR.

The Regional Collaborative is an independent network that invites all stakeholders in health systems to share their perspectives and aspirations by offering a safe, open and apolitical environment for stakeholders to discuss all health system governance issues, even the most sensitive.

The Regional Health Systems Governance Collaborative Chapter aims to support Eastern Mediterranean countries in developing country-led, actionable and best-fit approaches to health system governance through the following:

Following the Action Plan 2018-2020, the Regional Collaborative will support country-initiated work on collaborative governance and health stewardship in Lebanon, decentralization in Jordan, a legal and institutional review to implement social health insurance legislation in Egypt, and accountability assessment in Oman and the launching of country platforms in Iraq, Jordan, Morocco and Oman.

(sources: action plan, report of the consultation and TOR of the consultation)

About Sara Van Belle

Sara Van Belle is a Senior Research Fellow at the Institute of Tropical Medicine, Antwerp, Belgium.

About Hala Abou-Taleb

Regional Advisor, a.i. Policy and Health Planning, WHO Eastern Mediterranean Region

About Maged Iskarous

Independent Public Health Consultant
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