A realist evaluation of the role of health system governance in improving maternal and newborn health in resource limited settings.
Governance is defined as the rules (both formal and informal) of deciding collectively in a system with diverse players and organisations. Governance matters as it is concerned with how different actors in a system function and operate and the reasons behind this. Health systems governance is a relatively new concept, there are gaps in understanding what it comprises and how it should be assessed.
This operational research examined if and how health systems governance is associated with functionality of comprehensive emergency obstetric and newborn care (CEmONC) facilities in Kenya using a mixed method design.
The researcher used a combination of secondary data from an ongoing programme of work on strengthening the availability of EmONC (performance of health facilities as per signal functions) and empirical data collected using qualitative research methods to explore factors influencing governance and perspectives of key stakeholders. The conceptual framework to assess governance is adopted from published and validated frameworks identified from the literature.