Question

20) Provide an example of a political impact on healthcare delivery which might result in a constraint on services

Answer 1

Ans) Some common governance constraints and their symptoms and effects for service delivery. In doing so, we also start to provide deeper analysis of the potential opportunity
structures available to address recurrent bottlenecks or blockages that undermine sector performance or to explain why performance may be better in some areas than others.

- Thus, rather than discussing governance support in a generic sense, identifying some particular forms of governance constraints allows us to pinpoint more tailored strategies that may help to address or mitigate these. In addition, it potentially allows for greater insights into where reform is possible – where we are able to determine whether a particular constraint is likely to be binding or whether
there are strategies that will help to address and overcome it.

- This provides the starting point in what might be more effective or feasible theories of change for supporting reform processes in different sectors going forwards.

- We do not yet have a comprehensive list of effective strategies or a full library of examples where these constraints have been overcome; as a first step, we indicate below a number of areas where there is evidence of constraints being overcome that may provide valuable lessons for others.
- Moral hazard is not examined below, in part because it forms a different type of constraint, and was less well covered in the available literature.