Assessing Governance of the Health Care Delivery System in Malaysia

Measuring performance is critical to assess effectiveness of public health expenditure. Performance of health care delivery however relies on adequate accountability indicators as benchmark for efficiency. Individual programs sometimes track specific output but do not examine overall health care delivery system. This is difficult to measure but is critical if health care systems are to achieve their objectives. This paper suggests using good governance as accountability indicators to focus on performance in health care delivery system. In developing the framework for health care governance, five key issues are identified: role of the state vs. the market, role of the ministries of health vs. other relevant agencies, actors in governance, static vs. dynamic health care delivery system, and health care reforms. The framework permits diagnosis of the ills in the health care delivery system at the policy and operational level. The study on good governance in health has received little attention. Assessing the health care governance is the first step to ensure effective governance as the key determinant of Malaysia’s economic growth and social advancement.