Multi-level pro-poor health governance, statistical information flows and the role of regional organisations in South America and Southern Africa
Health governance has become multi-layered as the combined result of decentralisation, regional integration and the emergence of new actors nationally and internationally. Whereas this has in principle enhanced the installed capacity for health response worldwide, this complexity also poses serious challenges for health governance and policy-making.
This paper focuses on one of these challenges, namely the organisation of statistical information flows at and between governance levels, and the emerging role that regional organisations play therein. The authors aim to understand the extent to which statistics are regionally coordinated and the role regional organisations are playing with respect to national health information systems. Specifically, they analysed regional to national-level data flows with the use of two case studies focusing on UNASUR (Bolivia and Paraguay) and SADC (Swaziland and Zambia). Special attention is given to pro-poor health policies, those health policies that contribute to the reduction of poverty and inequities.
Results demonstrate that health data is shared at various levels, to a greater extent at the global-country and regional-country levels, and to a lesser extent at the regional-global levels. There is potential for greater interaction between the global and regional levels, considering the expertise and involvement of UNASUR and SADC in health. Information flows between regional and national bodies are limited and the quality and reliability of this data is constrained by individual Member States information systems. Having greater access to better data would greatly support Member States focus on addressing the social determinants of health and reducing poverty in their countries.