Beyond numbers, coverage and cost: adaptive governance for post-COVID-19 reforms in India

Rao, Neethi Varadaraja; Prashanth, N S; Hebbar, Pragati B

doi:10.1136/bmjgh-2020-004392

Cited by 10 publications

(8 citation statements)

References 15 publications

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“…12 Currently, the Indian public health system is not only highly fragmented and varied, but its governance is underdeveloped in both research and practice. 13 This has left India's population vulnerable to a host of health-related issues much like a computer with poor security against digital attacks.…”

Section: Whatispublichealth?mentioning

confidence: 99%

A Different Kind of Security: Public Healthcare in India

Krishnan¹

2022

J Indian Inst Sci

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Section: Whatispublichealth?mentioning

confidence: 99%

A Different Kind of Security: Public Healthcare in India

Krishnan¹

2022

J Indian Inst Sci

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“…On the other hand, there were limitations to governance arrangement in India’s COVID-19 crisis. Adaptive governance, delivered through a multidimensional and integrated health system agenda setting, was necessary to overcome the challenges of the country’s epidemic [ 28 ]. In Bangladesh, an adaptive response strategy allowed old and new networks of organizations to align and work collectively [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…On the other hand, the COVID-19 crisis in India is partly explained by the limitations of the centralised governance arrangement, which cannot account for the complexity of the health system. It was identified that the pandemic response necessitated increased operational decentralisation, which needs to be reinforced with greater autonomy, consultation, cooperation and coordination among different level actors [ 28 ]. The pandemic has also illustrated the need for liberating local clinical leaders and managers and empowering them to find their own solutions [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

Attributes of national governance for an effective response to public health emergencies: Lessons from the response to the COVID-19 pandemic

et al. 2022

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Background The Coronavirus Disease 2019 (COVID-19) pandemic takes variable shapes and forms in different regions and countries. This variability is explained by several factors, including the governance of the epidemic. We aimed to identify the key attributes of governance in response to the COVID-19 pandemic and gain lessons for an effective response to public health emergencies. Methods We employed a mixed-methods design. We mapped the attributes of governance from well-established governance frameworks. A negative binomial regression was conducted to identify the effect of the established governance measures on the epidemiology of the COVID-19 pandemic. We used publicly available data on COVID-19 cases and deaths in countries around the world. Document review was conducted to identify the key approaches and attributes of governance during the pre-vaccine era of the response to the COVID-19 pandemic. We conducted a thematic analysis to identify key attributes for effective governance. Results The established governance measures, including generation of intelligence, strategic direction, regulation, partnership, accountability, transparency, rule of law, control of corruption, responsiveness, effectiveness, efficiency, equity, ethics, and inclusiveness, are necessary but not sufficient to effectively respond to and contain the COVID-19 pandemic. Additional attributes of national governance were identified: 1) agile, adaptive, and transformative governance; 2) collective (collaborative, inclusive, cooperative, accountable, and transparent) governance; 3) multi-level governance; 4) smart and ethical governance: sensible, pragmatic, evidence-based, political, learner, and ethical. Conclusions The current governance frameworks and their attributes are not adequate to contain the COVID-19 pandemic. We argue that countries need agile, adaptable, and transformational, collaborative, multi-level, smart and ethical governance to effectively respond to emerging and re-emerging public health threats. In addition, an effective response to public health emergencies depends not only on national governance but also on global governance. Hence, global health governance should be urgently renewed through a paradigm shift towards universal health coverage and health security to all populations and in all countries. This requires enhanced and consistent global health diplomacy based on knowledge, solidarity, and negotiation.

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“…On the other hand, Walch, (2019) and Choudhury et al (2021) identified that the local community should be incorporated into the earliest stages of disaster management governance planning for sustainable disaster management in India and Bangladesh. The community actors have initiated the AG process in crisis health management in India and Bangladesh during the COVID-19 pandemic (Khan et al, 2020;Rao et al, 2020) and health governance in Africa (Olsson et al, 2007). Governance interventions should further be clearly co-designed to acknowledge and address the specific needs and context of the affected community and design stages by soliciting, then incorporating community feedback in natural resource management in Uganda (Sanginga et al, 2010) and water resource management in East Africa (Tuda et al, 2021).…”

Section: Community Involvementmentioning

confidence: 99%

Emerging attributes of adaptive governance in the global south

Akther,

Evans

2024

Front. Environ. Sci.

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Adaptive governance is widely considered an effective approach to address the complexities and uncertainties of socio-ecological systems. The application of adaptive governance to sustainable environmental governance in the global south has not been sufficiently explored. There is a gap in the literature in the global south, especially given its conceptual roots in the global north. A number of reviews identified some key conceptual and practical gaps related to adaptive governance principles and the challenges to implementing them. To address this gap, this paper presents a systematic literature review of adaptive governance scholarship focused on the global south published between 2003 and 2022. The review discusses adaptive governance’s key principles and framings, as well as the challenges of implementing it in the global south. This paper examines the factors that influence the emergence of adaptive governance and how this framing has been used to understand effective environmental governance within the global south’s diverse socio-political and institutional settings. The review specifically focuses on Africa and South Asia, which are densely populated with limited financial and institutional capacity. Sustainable environmental governance is crucial in these regions not only for the wellbeing of the population, but also for the health of the planet. A review of adaptive governance scholarship identified emerging attributes that improve government structures and processes, as well as proposed attributes that would minimize challenges and improve adaptive capacity. The key emerging attributes are formal and informal networks, social learning, community engagement and proposed attributes are flexible, integrated and participatory institutional governance, inclusive decision making, context-specific strategies, accountability, and capacity development. These attributes provide a framework for adaptive governance scholarship for examining different governance structures and processes in different socio-ecological systems. This paper concludes with a framework for future research that can facilitate adaptive governance in the context of sustainable environmental management in the global south.

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Beyond numbers, coverage and cost: adaptive governance for post-COVID-19 reforms in India

Cited by 10 publications

References 15 publications

A Different Kind of Security: Public Healthcare in India

A Different Kind of Security: Public Healthcare in India

Attributes of national governance for an effective response to public health emergencies: Lessons from the response to the COVID-19 pandemic

Emerging attributes of adaptive governance in the global south

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