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With increasing demand to cope with development calls, it was necessary for
all stakeholders and players in societies as governments, NGOs, corporates
and others to follow the new emerging concept of Governance.
Defining governance is ambiguous and there is much debate about exact
definition. Although the term is an old one, the meaning is a reviving concept
to the new model of public administration. In general, governance can be
defined as multiple ways to solve problems organizational, social or national.
Also, it can be defined as traditions and institutions by which authority in a
country

is

excersiced,

entailing

processes

of

government

selection

monitoring and replacement, policies formulation and imlementation and

entailing respect of social contract between people and state governed by
law.
The base of governance is the rule of the law which regulate
responsibilities and rights of different parties. Institute of Governance (IOG)
emphasizes that governance include the traditions, institiuttions, and
processes that define how power is excersides, how citizen express their
voice, and and how decisions are made regarding public concern.
World bank has defined the governance as the manner in which power is
exercised in the management of a countrys economic and social resources
for development.
Although governance term is trending nowadays, it is an old process which
highlight how decisions are taken and how they are implemented. Decision
making process depends on variable players according to situation and
setting of making decision. There are many influencers on decision making
process including formal and informal networks. Governance is considered as
bilateral process between citizens and government, which means that policy

makers take in their consideration the views and perception of citizens,

experts and firms. All institutions that go through governance processes
should be responsive to real need of communities through empowered civic
participation. Governances is a corner stone in combating inequalities in all
disciplines, that it play a great role in social development goals and quality of
life for those marginalized communities through their active participation.
Governance implementation should be flexible sufficiently to prioritize and
address context-specific challenges at all levels.
Newman (2001) has divided governance into 4 models 1) the hierarchical
mode which reflect the rule of old management school with emphasizing on
accountability and centralization. 2) the rational goal model that advocate
for managerial roles and output maximization. 3) open system model, that
support decentralization and more expansion. 4) self-governance model
where citizen has power with more participatory action.
As a step forward to measure governance, monitor country progress,
understand the causes of good governance and defining failure, Worldwide
Governance Indicators have been developed. It has been evident thatthere is
stron relationship between good governance and economic development,
that one standard deviation increase in any of indicators causes about four
fold increase in er capita incomes. The political, economic, and institutional
dimensions of governance are captured by six aggregate indicators. 1) Voice
and accountability which reflect civil society participation in decision making
process highlighting free media, free expression and freedom of associations.
2) Political stability and absence of violence 3) Government effectiveness,
that deals with quality issue of policies and public services and how far thery
are independent from political pressure. 4) Regulatory quality, about role of
government to steer private sector 5) Rule of law, which reflect how the rules
are confident and implemented.

The most important limitation to these indicators, they are not "actionable".
They cannot be used by stakeholders in the country, they only work with
external comparison. The other limitation is related to transparency of
indicators caused by limited access to source information used by this
indicators.
There is an evident relationship between democratic accountability and clean
government. Why not and free media with free expression methods which
aligned with democracy promote anticorruption measures and governments
become cleaner and more transparent. And this clarify the role of good
governance in combating corruption.
About governance in Egypt, there is a strong action for implementing
governance principals in healthcare industry. Egyptian healthcare system is
highly fragmented and suffers from chronic problems which clearly obvious
with high out of pocket spending and corruption. The main problems is facing
Egyptian healthcare system concluded in four items 1) Burden of growth in
total healthcare expenditure, 2) demand for infrastructure and quality 3)
needs for investments within the sector, and 4)Growing pressure for social
responsibility towards the population. In addition, Egypt is lagging behind
regarding good governance and transparency in this industry. In healthcare
ficnane there is no clear distinction between different healthcare providers
and buyers. Also, lack of accountability in perspective of regulations and
service provision. There is a bad need for rigourus analysis of healthcare
system regarding governing structure, institiutios and bodies to build
asystem that able to balance the power between different players, distribute
responsibilities, and foster accountability.
In brief, for better governance, in addition to build a solid information system
helping decision makers to make better policies, Egyptian healthcare system
should undergo radical changes within governing structure in aligned with
following principals. 1) spiliting ownership from management and defining

governance structure for different organizations to ensure accountability and

efficiency and help corruption reduction. 2)create distinction between
providers and regulators with well definition of services/products, to define
roles

of

healthcare

institute

regarding

treatment,

human

resource

development and research. 3) splitting between service buyers and service

providers, to ensure quality of services in competitive environment. 4)
splitting capital investment in infrastructure and funds operational costs, to
secure efficient services and return on investment. 5) independence of
representative bodies with defining their role in licensure without conflict of
interest with the government.
Refernces:
1- Lee,

(2003).

Instittutuion

of

Conceptualizing
Socila

the

Coordination.

New

Governance:

Institutional

New

Analysis

and

Development mini-Confercne Workshop in Political Theory and Policy

Analysis,Indiana University, Bloomington, Indiana, USA. Retrieved from
www.indiana.edu
2- Kaufman, D. (1999). Governance Matters. Policy Research Working
Paper, 2196. Retrieved from www.wbi.org
3- Hunter, M. (n.d.) Governance and transparency to Empower the
Healthcare Industry, the Case of Egytp. Retrieved from www.hegta.org
4- Oman, C. and Arndt, C. (2010). Measuring governance. POLICY BRIEF

No. 39 OECD