Fostering problem driven collaboration in a development context: The ASEAN study of health workforce governance

Abstract

Transnational challenges such as societal ageing, rapid epidemiological transitions from managing chronic disease and infectious disease such as COVID-19, and environmental vulnerabilities raise urgent concerns for collaborative governance. This study addresses the challenges of monitoring outcomes and accountabilities i n a development context. Problem-driven collaboration, with a focus on identifying urgent, locally defined problems offers a potential solution to designing relevant performance management systems. Based on a case-survey design, the study analyses two collaborative governance networks in the Association of Southeast Asian Nations (ASEAN) promoting the mobility of health workers. The analysis draws on 20 (n = 20) in-depth interviews with high-level country delegates and officials and a content analysis of 380 confidential reports from 10 countries in ASEAN. The results provide a deeper understanding of how a problem-driven approach can foster collaborative governance and overcome barriers to policy implementation. Implications for monitoring practices include the role of measuring "felt needs"perceived gaps in implementation of policy objectives, and how problem-driven collaboration can add value to performance management systems in a development context.

Governance in health workforce: how do we improve on the concept? A network-based, stakeholder-driven approach

“…Of the remaining sources, seven were broader systematic reviews, literature reviews, scoping studies, case studies or books that were able to consider governance more generally within health workforce [ 5 , 26 - 31 ], two were region-wide examinations of HRH units within countries [ 32 , 33 ], and six were editorials, research articles or other grey literature [ 7 , 34 - 38 ]. One publication was considered exceptionally due to its discussion of health workforce governance from a public administration perspective [ 39 ]. Six publications (including 1 editorial) were extracted from the ‘Health Workforce Governance in Europe’ special issue of Health Policy (Volume 119, Issue 12, December 2015).…”

“…In summary, the conceptualisation of governance in health workforce literature is either process driven, outcome focused or both. Much of the literature extrapolates the concept of governance ad hoc from health governance; however, apart from the work of Kuhlmann et al [ 24 , 25 ] and more recently Teter [ 39 ], there has been little adaptation or tailoring of governance perspectives towards the specific characteristics and challenges within the health workforce.…”

“…Instead of viewing governance at the domestic level as a public policymaking affair effected primarily in a top-down fashion, an improved conceptualisation of health workforce governance sees the governance process as network-based and stakeholder-driven. Teter previously argued for problem-driven collaborative governance in health workforce which emphasises stakeholder engagement and accountability through robust feedback loops [ 39 ]. In this frame, governance refers not only to the processes through which responsibilities are distributed amongst different actors, but also the relationships and connections within a complex web of interlinked stakeholders wishing to influence the processes of governance.…”

“…Traditionally, a network governance-based approach has rarely been discussed within health literature and remains a concept developed from business and public policy contexts [ 39 ]. We advocate for a ‘brokered-network’ model where the government still retains key ‘broker’ functions (most notably in legislation, public financing and stewardship) whilst other responsibilities are devolved to stakeholders [ 46 ].…”

Monitoring implementation of the Tokyo Convention on recognition: a multi-stakeholder approach to the internationalization of higher education in the Asia-Pacific

“…However, accountability itself involves multiple sub-dimensions, including transparency, liability, controllability, responsiveness and responsibility (Koppell, 2005). Taken together, effective monitoring of diverse outcomes and accountabilities can also inform relevant areas for collaboration (Teter, 2020). To promote mutual accountability among diverse stakeholders, UNESCO has a unique role in international higher education, including to address gaps and opportunities in cross-border mobility governance.…”