Towards people-centred health systems: a multi-level framework for analysing primary health care governance in low-and middle-income countries

Although there is evidence that non-government health system actors can individually or collectively develop practical strategies to address primary health care (PHC) challenges in the community, existing frameworks for analyzing health system governance largely focus on the role of governments, and do not sufficiently account for the broad range of contribution to PHC governance. The paper presents a multi-level governance framework for use as a thinking guide in analyzing PHC governance in LMICs. Using the example of PHC governance in Nigeria, the paper illustrates how the multi-level governance framework offers a people-centred lens on the governance of PHC in LMICs, with a focus on relations among health system actors within and between levels of governance.

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Abimbola S, Negin J, Jan S, Martiniuk A. Towards people-centred health systems: a multi-level framework for analysing primary health care governance in low-and middle-income countries. Health Policy and Planning. 2014;29(suppl 2):ii29-ii39. doi:10.1093/heapol/czu069