[Governance and health: meaning and implications in Latin America]

Abstract

The term governance is used more and more often in the formulation, implementation, and evaluation of public policies. The purpose of this paper is twofold: to shed light on its meaning, and to study its applicability for the study of recent public health policies in Latin America. After discussing the differences between governance and the close concepts of management, governability and government, we propose the adoption of the notion of Giddens' duality of social structure for better understanding of the governance processes. Then we use this theoretical framework for reviewing the conceptual and empirical implications of the set of papers about governance and health in Latin America included in the present special issue of the Journal of Public Health. Recognizing that the debate on governance is not closed, we end the paper highlighting the main contributions of the revised works, namely: the importance of equity in decision-making processes, the appreciation of the political nature of governance, and the advantages and limitations of the clan mechanism of governance for regulating interactions among actors involved in the health policy decision-making processes.