Impacts of health care investments in developing and transition countries are typically measured by inputs and by health outcomes. Missing are measures of performance that reflect whether health systems are meeting their objectives, public resources are being used appropriately, and the priorities of governments are being implemented. Between inputs and outputs, and between outputs and outcomes, are the institutional and public sector actions that define performance.

Maureen Lewis will present a framework for thinking about governance issues as a way to improve performance in the health sector, and enhance the impact of investments in that sector. Basing her arguments on a wide range of evidence from low and middle income countries, she will explore what we do and do not know about effective solutions to advance good governance and performance in health service delivery, drawing on existing research and documented experience.