A survey of the governance capacity of national public health associations to enhance population health.

James Chauvin,Laetitia Rispel,James Rice,Mahesh Shukla

doi:10.1186/s12889-016-2935-y

Abstract

BackgroundNational public health associations (PHAs) are key partners with governments and communities to improve, protect and promote the public’s health. Governance and organizational capacity are among the key determinants of a PHA’s effectiveness as an advocate for appropriate public health policies and practice.MethodsDuring 2014, the World Federation of Public Health Associations (WFPHA) conducted an on-line survey of its 82 PHA members, to identify the state of organizational governance of national public health associations, as well as the factors that influence optimal organizational governance. The survey consisted of 13 questions and focused on the main elements of organizational governance: cultivating accountability; engaging stakeholders; setting shared direction; stewarding resources; and, continuous governance enhancement. Four questions included a qualitative open-ended response for additional comments. The survey data were analyzed using Microsoft Excel. The qualitative data was analyzed using thematic content analysisResultsResponses were received from 62 PHAs, constituting a 75.6 % response rate. The two most important factors that support governance effectiveness were a high degree of integrity and ethical behavior of the PHA’s leaders (77 %) and the competence of people serving on the PHA’s governing body (76 %). The lack of financial resources was considered as the most important factor that negatively affected organizational governance effectiveness (73 %). The lack of mentoring for future PHA leaders; ineffective or incompetent leadership; lack of understanding about good governance practices; and lack of accurate information for strategic planning were identified as factors influencing PHA governance effectiveness. Critical elements for PHA sustainability included diversity, gender-responsiveness and inclusive governance practices, and strategies to build the future generation of public health leaders.ConclusionNational PHA have a responsibility to put into place the practices and infrastructure that enhance organizational governance. This will enhance their ability to be effective advocates for policies and practices that enhance, protect and promote the public’s health. The WFPHA has an important role to play in providing the technical assistance and financial resources to assist PHAs in attaining and sustaining a higher level of governance capacity.

Highlights

National public health associations (PHAs) are key partners with governments and communities to improve, protect and promote the public’s health
Ethics statement The 2014 survey was part of ongoing assessments conducted by the World Federation of Public Health Associations (WFPHA) to determine what support it should provide to member associations to enable them to fulfill their mandates as national PHAs
In concert with the 2013–2017 WFPHA Strategic Plan that highlights the importance of effective organizational governance, [30], this survey aimed to determine the views of the WFPHA members on factors that influence governance effectiveness of PHAs, the extent to which PHAs adhere to good governance practices, and the role of the WFPHA in enhancing PHAs’ organizational capacity and effectiveness

Summary

Introduction

National public health associations (PHAs) are key partners with governments and communities to improve, protect and promote the public’s health. Governance and organizational capacity are among the key determinants of a PHA’s effectiveness as an advocate for appropriate public health policies and practice. Key elements of good governance for health include: evidence-informed decisionmaking; shared values of equity and social justice; transparent and inclusive processes; responsiveness to the needs of the people or beneficiaries; accountability by those who make or implement decisions; efficient and effective implementation of strategic objectives; and maintenance of organizational vitality [8, 18, 19]. Capacity for governance is an important determinant of good public health practice [20], as it enables improved population health outcomes and returns on health investment [21, 22]. Insufficient attention has been given to the role of organizational governance, effectiveness and capacity in influencing health policy and practice in order to enhance population health [17, 18, 24]

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Conclusion