Related Institutions Research Articles

Designing intermediary-involved regulatory system: organizational capacities and institutional conditions for NGO regulatory intermediation

ABSTRACT Regulatory intermediaries (RIs) are transforming implementation of contemporary regulatory policy. While the mainstream Regulator-Intermediary-Target framework offers important insights, limited research investigates the prerequisites for non-governmental organizations (NGOs) to function as RIs. This study investigated the organizational capacities and institutional conditions for environmental NGOs’ contributions as RIs in China’s newly established Environmental Public Interest Litigation system. Analyzing data from interviews, archive retrieval and participatory observation, it found that their effective contributions require not only adequate capabilities and competences for the assigned authorities, but also alignment of their strategic and survival interests with the broader regulatory objectives. The contributions were influenced by their interactions with other key actors in the regulatory system and related institutions. The study suggests that researchers and designers of regulatory systems relying on NGO-RIs should consider their organizational capacities and interests in their evolving interactions with actors within and beyond the focal system and before and after its introduction. Constant feedback about their latest operational needs and concerned issues would help update the regulatory system. Institutional arrangements that support their development would also enable their effective functioning for the system, inducing wider and more dedicated contribution. The study highlights the complexity in governing with NGOs.

The Sacred Federation of Tibet and the Mongol Empire

This article re-examines the history of the Mongol Empire’s rule over Tibet, analyzing the complex institutional and religious relationships between the Mongol Empire and Tibet from an innovative perspective. We find that, unlike its military conquests in other parts of the world, the Mongol Empire actually formed a kind of federation with Tibet based on Buddhism. The Mongol Empire embraced Tibetan Buddhism as its state religion and venerated the head of the Sakya school as a spiritual guide. Concurrently, the establishment of the Bureau of Buddhist and Tibetan Affairs in the Mongol capital served as a nominal governing body over Tibet, while in reality, it ensured a significant degree of autonomy for the region. Furthermore, the leaders of the Mongol Empire felt endowed with the legitimacy to conquer the world after being blessed by Tibetan Buddhism as Mahakala, the dark incarnation of Avalokiteshvara. In addition, the article also provides a detailed account of the prosperity of Buddhism within the Mongol Empire, in terms of its economic, artistic, and philosophical aspects. The discovery of this evidence is of great significance, since it not only supports reinterpretation of the historical evolution of the Mongol Empire and Tibet, but also allows us to observe the status of Tibetan Buddhism in the Mongol Empire from a new perspective, and to explore the unexpected institutional innovations of the federation reflected in the Mongol-Tibetan relationship.

Transformation of Criminal Law in Indonesia: An Analysis of Social Rights Protection through a Qualitative Descriptive Approach

This research aims to analyze the protection of human rights in criminal law in Indonesia, considering the importance of integrating human rights protection into a fair and effective criminal law system. This study uses a qualitative descriptive research method, utilizing primary data from case studies related to human rights violations and secondary data in the form of scientific literature, laws, and official documents from related institutions. Data were collected through documentation study techniques and media content analysis, which allowed for in-depth exploration of various cases and legal policies that had been implemented. Content analysis was used to identify key themes in legal documents and literature studies, while theoretical modeling helped formulate a theoretical model that links criminal law to human rights protection. The results of the study indicate that there is a discrepancy in several implementations of criminal law with human rights principles, especially in terms of protecting victims and fulfilling the rights of the accused. The conclusions obtained highlight the need for criminal law reform to ensure the fulfillment of basic rights for all individuals in accordance with international standards. This study provides recommendations for policymakers to integrate human rights protection more systematically into the criminal law system in Indonesia.

Gambaran Kondisi Psikologis dan Coping Stres Staf Klinik IPWL BNN RI dalam Melayani Klien Penyalahgunaan Narkoba

The number of drug users in Indonesia tends to increase every year, which leads to a rise in the number of cases that need to be handled by various related institutions, including the clinics of the Compulsory Reporting Institution (IPWL) of BNN RI. This study aims to describe the psychological condition and stress coping strategies used by the staff of IPWL BNN RI clinics in dealing with work pressures while serving clients with drug abuse problems. A qualitative approach with a phenomenological method was used to explore the staff’s subjective experiences regarding work-related stress and how they cope with it. Data were collected through in-depth interviews with two subjects and two informants who are clinic staff members. The results of the study indicate that the primary sources of stress stem from workload and difficult client demands. The staff employ two main coping strategies, namely emotion-focused coping and problem-focused coping. Although the stress experienced is quite significant, both subjects are able to manage it well, ensuring that it does not affect their overall performance.

Land Parcel-Based Land Valuation System Development Strategy in Indonesia with The Concept of Multi-Purpose Cadastre

Abstract Currently, the Land Value Zone (ZNT) Map provides information about land values in Indonesia. The main problem with using Land Value Zones is that there is no difference in the value of land parcels in one zone even though they have different locations and access. This causes the value of land obtained from Land Value Zones to not reflect the actual conditions in the field, so it is often not used by related institutions, especially in tax collection. This study aims to formulate a practical land valuation policy approach that follows Indonesia’s objectives. The research method used in writing this article is a descriptive qualitative method. The primary data collection method used was in-depth interviews with key stakeholders related to the land valuation system in Indonesia. To find out the situation that is being carried out in the land valuation system in Indonesia, a SWOT analysis is used. The research has produced 5 policy recommendations to build a land valuation system in Indonesia regarding man, method, machine, material, and money.

Short-Term and Long-Term Effects of the Islamic Bank Financing in Construction Sector on GDP in Indonesia

Research on the role of Islamic banks on economic growth has been widely conducted. However, it focuses on total Islamic Bank Financing (IBF) rather than on sector-specific Islamic financing. This research addresses the gap by examining the short-term and long-term influence of Islamic bank financing in the construction sector on the Gross Domestic Product (GDP) in Indonesia. This research uses a quantitative approach, using the Conditional Error Correction Model (CECM) analysis method. Secondary data used in this research are from the first semester of 2006 to the first semester of 2023 and are taken and processed from related official institutions such as Bank Indonesia, the Central Statistics Agency, and the Financial Services Authority. In the autoregressive distributive lag (ARDL) model in the construction sector, IBF’s short-term impact on GDP is positive but insignificant, while the long-term effect is significantly positive.

The Role of Law in Regulating Compulsory Vaccination: Between Human Rights and State Obligations during the Pandemic

Public health protection is one of the main obligations of the state in an effort to maintain the welfare of its citizens. One of the policies implemented is mandatory vaccination to reduce the spread of infectious diseases and maintain collective health. However, this policy raises challenges in terms of balancing between the state's responsibility to protect the community and individual human rights, especially the right to determine which medical interventions to accept. This research aims to examine the role of law in regulating mandatory vaccination in Indonesia, as well as how the policy can be implemented without violating human rights. This study uses a normative juridical approach by exploring various regulations that form the basis for the implementation of mandatory vaccination in Indonesia, including Law Number 36 of 2009 concerning Health and Presidential Regulation Number 99 of 2020 concerning Vaccine Procurement and Vaccination Implementation. The analysis shows that compulsory vaccination has a strong legal footing to protect public health, but it must still respect individual rights, especially the right to choose medical interventions. The state is also required to ensure that this policy is implemented in a fair and non-discriminatory manner, especially for vulnerable groups such as children, the elderly, and individuals with special health conditions. This study also found that adequate education and socialization are important factors to increase public acceptance of mandatory vaccination. Public opposition is generally caused by a lack of proper understanding of the benefits of vaccines, as well as the spread of inaccurate information about vaccine safety. Therefore, a more persuasive approach, involving community leaders and related institutions, is needed to provide better understanding and increase public trust in vaccination policies. Mandatory vaccination policies need to be implemented while maintaining a balance between the state's obligation to protect public health and human rights. Not only does the state need to strengthen the legal basis for vaccination, but it must also ensure that this policy is implemented in a fair and inclusive manner.

Challenges and Benefits of Sports for the Elderly: A Case Study in Panimbang District, Banten, from the Perspective of the Elderly and Health Professionals

Aging is a natural process that causes significant changes in many aspects of life, including physical and psychological aspects. As older people age, they often experience a decline in physical function, which can lead to reduced mobility and an increased risk of various chronic diseases such as diabetes, hypertension, and osteoporosis. One way to improve the quality of life of the elderly is through exercise. Regular exercise can help maintain or improve the physical and mental health of the elderly, improve sleep quality, and reduce symptoms of stress, anxiety, and depression. However, the elderly often face various barriers to exercise, such as physical limitations, fear of injury, and lack of elderly-friendly sports facilities. Therefore, it is important to explore the challenges faced by the elderly when exercising and how to overcome these barriers. This study used a qualitative approach with a case study in Panimbang District, Banten, involving 15 elderly and 8 health workers. Data were collected through in-depth interviews, focus group discussions (FGDs), and observations of elderly sports activities. The results showed that despite various challenges, elderly who exercise regularly reported significant physical and mental benefits, such as reduced joint pain, increased mobility, and reduced stress and improved sleep quality. It was also found that health workers face challenges in providing specific training on exercise for the elderly and managing the risk of injury. However, they acknowledge the benefits of exercise in improving public health, reducing chronic diseases, and increasing patient satisfaction. It is recommended that the government and related institutions pay attention to providing elderly-friendly sports facilities and provide training for health workers so that exercise programs can be implemented safely and effectively.

Rural Development as a Basis for Food Security of The Union State: Methodology of an Integrated Approach

In this article, the author, based on a study of the current situation, systemic problems and regulatory decisions related to the situation of rural areas of the Russian Federation, proposes a number of conceptual points to strengthen the regulatory functions of the Union State institutions in relation to rural development, which could contribute to building up integration processes as part of a large association. The essential point of the article is that rural areas, as the organic basis of agro-industry, are the most important factor in food security both at the national level and at the level of the Union State. According to the author, the village today bears the main burden of protecting our Motherland, therefore it is unreasonable to save on the development of rural areas — and state regulation of rural development should be carried out as part of a program-oriented and goal-oriented approach, in the implementation of which a system of standards is used to determine the numerical values of target indicators.

Implementation of network management in child protection policy: Analysis of mobilization strategy in Makassar City

This study aims to examine network management in the implementation of child protection policies in Makassar City, with a focus on mobilization strategies implemented by the Office of Women's Empowerment and Child Protection (DP3A). The research method used is a qualitative approach with data collection techniques through interviews, observations, and document studies. Informants in this study include representatives from DP3A, Makassar Police, Institute for Public Policy Studies (LSKP), and other related institutions. The results show that the mobilization strategy implemented by DP3A Makassar City, which includes motivating and rewarding networks, utilizing digital platforms, and cross-sector collaboration, has succeeded in increasing the effectiveness of child protection policy implementation. This success is in line with network management theory. DP3A Makassar City has managed to gather and utilize various resources, strengthen cross-sector collaboration, and accelerate responses to child abuse cases. The use of digital platforms and continuous evaluation are also key factors in the success of child protection efforts in Makassar City. This research provides recommendations for strengthening inter-agency coordination and collaboration through the establishment of regular coordination forums, developing efficient information and data exchange mechanisms, and establishing an integrated referral system. Future research is expected to develop a network management model or framework that can be adapted and applied in the context of child protection at the local, regional and national levels in Indonesia.

Spatiotemporal evolution characteristics and influencing factors of digital industry in China

In the era of the global knowledge economy, the rapid advancement of new-generation information technologies has positioned digital industry at the forefront of socio-economic development. Digital industrial clusters, comprising key enterprises and related institutions, have emerged as global hubs for technological innovation, drawing recognition from governments and international organizations. However, China’s digital industry faces challenges characterized by being “large but not strong” and experiencing “industrial structure softening.” This paper explores the temporal evolution and spatial distribution of China’s digital industry, shedding light on its unique patterns. This study reveals that China’s digital industry has progressed through four distinct phases, evolving from manufacturing-oriented to service-oriented, and experiencing dynamic stability. In terms of spatial distribution, it exhibits a pattern known as the “One Core, Three Poles, and Multiple Strongholds,” with Beijing as the core and Shanghai, Shenzhen, Hangzhou, among others, serving as growth poles. The study identifies factors influencing spatial distribution, including software development, patent authorizations, mobile phone penetration, industrial parks, digital finance, and foreign investment. Manufacturing-based digital industries prioritize innovation and IP protection, while service-based sectors rely on software development, innovation, and international collaboration. The GWR model demonstrates spatial variation, emphasizing the importance of tailored development strategies. This research contributes to understanding the dynamics of China’s digital industry and provides valuable insights for policymakers aiming to create an internationally competitive digital industry cluster.

Terminological Conflation in Archaeological Site Institutions: Delineating Boundaries through Interviews with Heritage Experts in Europe, China, and Israel

ABSTRACT As a fundamental component of cultural heritage, archaeological sites are protected and interpreted by diverse related institutions. However, the conceptual boundaries of these institutions are increasingly becoming blurred, resulting in theoretical ambiguities and a conflation of terminologies. This trend presents a risk of misinterpretation or misuse of terms, as evidenced in certain academic papers and institutional namings. A review of prevalent concepts across diverse geographical contexts of these institutions, coupled with the proposal of clearer theoretical definitions, may offer novel and valuable insights into their theoretical boundaries and enhance academic and public comprehension of the exact roles and functions of heritage institutions. This study – integrating an interdisciplinary literature review and field case studies with 16 semi-structured in-depth interviews with heritage experts in Europe, China, and Israel – aims to address current misconceptions and overlaps in the definitions of these institutions, analyse their scope variance across cultural regions, and advocate for diverse and open definitions.

From a Community to a ‘Scheduled Tribe’: A Ethnographic Study of the Hatti

The Hatti community of the Trans-Giri region of Sirmaur District with its recent inclusion in Article 342 of the Indian constitution was designated as Scheduled Tribe (ST). The research article is an ethnographic account of the Hatti Tribe of the Trans-Giri region of Sirmaur District, Himachal Pradesh. The study documents the rich culture and tradition of the Hattis in the existing social institutions of caste, family, marriage, kinship, political organisation and religion on account of fieldwork that was conducted in seven villages. The caste system of the Hatti observes strict defined hierarchies, their pre-determined roles and often determines occupation. It is divided into upper, middle and lower caste, with each caste further divided into sub-categories. The institution of kinship amongst the Hattis is unique and the recognition of kin is extended to the father’s father brother family such that kinship is identified and terminology is used for father’s father family. In addition, they recognise both consanguine and affinal kin and there is no distinct kinship term for lineal and collateral kin. The institution of marriage is also unique in its own way with five types of marriages that are known to take place in the area. Some of them are polyandrous marriage, monogamous marriage, remarriage usually/often after divorce, child marriage and marriage by elopement. Interestingly, all marriages have a different cultural process to solemnise the wedding. The political organisation of the Hattis is known by Khumbli, a traditional council that governs the law and order in the villages, is categorised as per village territories and is still considered the first place to resort differences. There is a close relationship between political and religious organisation such that many a times dispute resolution may take place at the deity level. The Hatti reflect a similar culture and tradition to the Jaunsari, a recognised ST in Uttarakhand. The existing Daichara between the two tribes is one of the strong indicators of common ancestral lines. The ethnographic account of the Hatti tribe in the research article is the first of its kind that documents the culture of the Hatti after they were granted the status of the ST before it embarked on the journey of planned development.

A Systematic Review for The Development of Sustainable Tourism Destinations Based on Sports Tourism

The study purpose: The project's goal is to develop sustainable tourism destinations in Kemuning Village by reviewing the literature on sports tourism Materials and methods: An extensive literature review was carried out. Articles from 2015 to 2024 covered ways to enhance sustainable tourism by fostering the growth of sports tourism. For electronic searches, Google Scholar, PubMed, Web of Science, and Scopus are used. All the articles that discuss how to improve sports tourism-based tourist attractions are included here. Results: According to the integrated theory of tourism, sports have a role in (1) tourism management strategies, which include methods, facilities, tourist attractions, SOPs, infrastructure, additions and maintenance of facilities, sustainable management of natural resources, and visitor security and safety; (2) the role of stakeholders, which includes the government as a regulator and related institutions; and (3) the role of the authorities, which includes government agencies and institutions related to Sports tourism will increase visits to Central Java and improve the economy. Sports activities in tourist destinations can benefit local governments, enhance community welfare, and create more job opportunities if they are appropriately managed. Sports tourism and activities can be combined in Central Java. Conclusions: Combining sporting activities like river tubing, paragliding, tea gardens, and jeep communities with Kemuning Village in Ngargoyoso District, Karanganyar, Central Java, Indonesia, can help the village grow its tourism industry due to the fact that it influences the social, cultural , and economic growth of the area, promoting local advancement.

Analisis Pemasaran Kelapa Sawit Rakyat Desa Perdomuan Nauli Kecamatan Kandis Kabupaten Siak Provinsi Riau

Indonesia, as an agricultural country, has an agricultural sector that contributes significantly to the national economy. Palm oil is the main commodity that plays an important role in increasing state income, especially in Perdomuan Nauli Village, Kandis District, Riau. This research aims to analyze palm oil marketing in the village using descriptive methods. Primary data was obtained through interviews and questionnaires, while secondary data came from literature and related institutions. The research location was selected through purposive sampling involving 35 respondents who used three main marketing channels: Farmers–Collectors–RAM–PKS, Farmers–Collectors–PKS, and Farmers–RAM–PKS. The research results show that the Farmer–RAM–PKS channel provides the highest profits for farmers with a margin of IDR 434.3/kg, followed by the Farmer–Collector–PKS channel with a profit of IDR 234.3/kg. The Farmer–Collector–RAM–PKS channel, even though it is the longest, still provides profits for farmers of IDR 139.3/kg. Each channel has its own advantages and disadvantages, depending on the facilities provided and marketing costs incurred. This research emphasizes the importance of evaluating and improving marketing channels to increase the efficiency and welfare of oil palm farmers in Perdomuan Nauli Village

Analysis of the Role of Digital Marketing in the Development of Micro, Small and Medium Enterprises (MSMEs) in Cibinong District

This study aims to analyze the role of digital development marketing in supporting the growth of Micro, Small, and Medium Enterprises (MSMEs) in Cibinong District. Along with the increasing internet penetration and use of social media, digital marketing has become a strategic tool to increase market reach and competitiveness of MSMEs. The research method used is descriptive qualitative, with data collection through interviews, observations, and literature studies. The results of the study indicate that MSMEs that implement digital marketing are able to increase sales, expand market share, and strengthen product branding. However, there are still obstacles in the form of a lack of digital knowledge and access to technology, especially among micro-scale MSMEs. Therefore, support is needed from the government and related institutions to improve digital literacy and provide infrastructure that supports the development of digital marketing in this region. Overall, the role of digital marketing for MSMEs in Cibinong District is very significant in increasing competitiveness, efficiency, and market reach. However, to maximize this potential, collaborative efforts are needed between MSME actors, the government, and technology service providers so that existing challenges can be overcome properly. This study is expected to be a reference for the development of effective digital marketing strategies for MSMEs in Cibinong District.

The Historical Roots behind the Libyan State Failure

Abstract This paper discusses the phenomenon of state failure in general and uses the current Libyan state as a case study by tracing the historical path of the formation of the modern Libyan state, specifically the impact of the legacy left by the Gaddafi regime on three main variables: authority, legitimacy, and institutional capacity. It addresses the following question: How did the historical legacy of the Gaddafi regime contribute to the crisis of the Libyan state after 2011? The study is based on the hypothesis that personal authoritarian regimes, such as Gaddafi’s, have the most detrimental impact on institutions in relation to the monopoly of violence, legitimacy, and capacity. This is because the ruling elites in personalistic authoritarian regimes are often unable to restrain the decisions and actions of the head of the regime, who often seeks to dismantle institutions that could limit their power. This contrasts with other types of authoritarian regimes (monarchy, military, one-party) that may, to some extent, maintain institutional rules for governance and the transfer of power.

Evaluating perspectives, knowledge and behaviors of osteopathic medicine in a United States osteopathic medical school: A study in employee education and changes in understanding

BackgroundThe institutional culture where students complete training may significantly impact their professional identity and practice habits related to osteopathic medicine principles and the use of Osteopathic Manipulative Treatment (OMT). This is the first study to evaluate institutional culture, perspectives, knowledge, behaviors, and the effect of an educational intervention among an institution's employees surrounding the principles of osteopathic medicine. ObjectiveTo explore the impact of a standardized educational intervention in osteopathic medicine for employees in promoting greater integration of osteopathic principles and practice into our institutional culture at a single multi-campus institution.. MethodsA cross-sectional study was conducted to assess osteopathic knowledge, perspectives, and behaviors through two surveys provided before and 6 months after an educational intervention. The educational intervention consisted of 7 online, asynchronous modules. A baseline (PRE) survey and 6-month follow-up (POST) were treated as independent samples, as not all study respondents participated in the educational intervention. Contingency tables were generated for the preliminary data set to assess the relationships among survey responses. Chi-square tests were conducted to test relationships and Fisher Exact Tests employed when assumptions for the chi-square test were not met. Analyses of variance and independent t-tests were conducted to evaluate score differences across different employment categories and backgrounds. ResultsAll employees were invited to participate in the study, 96/370 (25.9 %) completed the PRE and 94/370 (25.4 %) completed the POST surveys. In the POST survey, 45/94 (47.9 %) of respondents indicated they participated in the educational modules. After the training, a greater number of participants agreed or strongly agreed that they understand the fundamentals of OPP [PRE: 80/95 (84.2 %); POST: 88/92 (95.7 %); P = 0.01] and the origins and history of osteopathic medicine in the United States [PRE: 62/94 (66 %); POST: 79/92 (85.9 %); P = 0.003]. Within the administrators/staff category, significantly more had experienced OMT at the end of the study [PRE: 38/48 (79.2 %); POST: 45/48 (93.8 %); P = 0.04]. There were significantly more participants who correctly identified body systems impacted by OMT [PRE: 68/96 (70.8 %); POST: 79/93 (84.9 %); P = 0.01]. Faculty planned to integrate osteopathic principles into their teaching [37/40 (92.5 %)] and written exam items [25/40 (62.5 %)] in the future. Finally, employee participants in the training [50/51 (98 %)] reported an impact on their confidence in discussing Osteopathic Principles and Practice (OPP) with others, and believed the training increased their awareness of OPP in their work [46/51 (90 %)]. ConclusionsAn educational intervention positively impacted employees’ perspectives, knowledge, and behaviors related to OPP at a multi-campus, osteopathic institution. Enhanced engagement with institutional osteopathic culture fosters an informed workforce, and may influence student engagement with OPP in their future practice. Implications for educational practice•An educational intervention in osteopathic principles positively impacts the perspectives, knowledge, and behaviors of employees of an osteopathic institution in relation to Osteopathic Principles and Practice.•Providing focused training in osteopathic principles to employees may result in fewer misunderstandings within osteopathic organizations.•Employees trained in osteopathic principles may provide more consistent public messaging, enhancing public awareness about the osteopathic medical profession.•Institutions who seek to increase employee knowledge about osteopathic principles may influence student engagement with osteopathic principles and osteopathic manipulative treatment, furthering the distinctiveness of osteopathic medical practice.

The role of governance in shaping health system reform: a case study of the design and implementation of new health regions in Ireland, 2018–2023

Abstract Background This study focuses on the development of new regional health structures in Ireland in the period 2018-2023, one part of a broader health system reform programme aimed at greater universalism, in order to scrutinise how aspects of governance impact on the reform process, from policy design through to implementation. Methods This qualitative, multi-method study draws on document analysis of official documents relevant to the reform process, as well as twelve semi-structured interviews with key informants from across the health sector. Interviews were analysed according to thematic analysis methodology. Conceiving governance as comprising five domains (Transparency, Accountability, Participation, Integrity, Capacity) the research uses the TAPIC framework for health governance as a conceptual starting point and as initial, deductive analytic categories for data analysis. Results The analysis reveals important lessons for policymakers across the five TAPIC domains of governance. These include deficiencies in accountability arrangements, poor transparency within the system and vis-à-vis external stakeholders and the public, and periods during which a lack of clarity in terms of roles and responsibilities for various process and key decisions related to the reform were identified. Inadequate resourcing of implementation capacity, competing policy visions and changing decision-making arrangements, among others, were found to have originated in and continuously reproduced a lack of trust between key institutional actors. Conclusions Large scale health system reform is a complex process and its governance presents distinct challenges and opportunities for stakeholders. To understand and be able to address these, and to move beyond formulaic prescriptions, critical analysis of the historical context surrounding the policy reform and the institutional relationships at its core are needed

Governance and health system reform: a case study of new health regions in Ireland, 2018-2023

Abstract Background While the significance of good governance is recognised within health systems research, its role in health system reform is underexplored. This research focuses on the establishment of new decentralised regional health structures in Ireland in the period 2018-2023, examining how aspects of governance impacted the decentralisation reform process, from policy design through to implementation. Methods The research applied a qualitative, multi-method approach involving analysis of official documents relevant to the regional decentralisation process, and 12 semi-structured interviews with key informants from across the health sector. The research applies the TAPIC framework for health governance as its analytic framework and the data is analysed using thematic analysis. Results Deficiencies in accountability arrangements, poor transparency within the system and vis-à-vis external stakeholders, and a lack of clarity of roles and responsibilities for various process and key decisions related to the reform were identified as undermining progress at various stages of Ireland’s decentralisation reform process. An underlying distrust between key institutional actors was identified. These findings are grounded in complex social, cultural, and political and institutional developments in Ireland’s history. Also of note is the interwovenness of the five TAPIC domains and the importance of engaging with the complexity and relationality intrinsic to health system reform processes to achieve the aim(s) of the reform in question. Conclusions Large scale health system reform is a complex process and its governance presents distinct challenges and opportunities for stakeholders. To understand and address these, critical analysis of the historical context surrounding the policy reform and the institutional relationships at its core are needed. Key messages • Governance plays a crucial if overlooked role in health systems reform. Effective governance arrangements are central to the successful design and implementation of reform initiatives. • Ensuring a strong link between policy design and implementation processes is crucial to the success of health systems reform.