La gobernanza del sistema de salud colombiano desde la perspectiva de los actores

Although health governance can bring benefits, such as higher public spending, control of corruption, higher levels of participation and better management, there is no unified notion of the term or the associated processes. The aim of this research is to understand the actors’ perspective on the governance of the Colombian health system. To this end, a qualitative study is carried out, based on the application of a survey with structured and open questions to 141 leaders of the health system, under a non-probabilistic convenience sampling. The analysis shows a low knowledge of the term governance. Governance is rated at a low level (2.5/5.0), as are its key functions (2.6); with citizen participation, transparency and accountability being the worst rated. In addition, there knowledge of the Coordination and Advisory Body and the Intersectoral Commission on Public Health is lacking, and the contribution of both to the system’s objectives is considered low. Most of the participants pointed out corruption as the main problem of the system (72%), in addition to the articulation of actors (41%) and lack of financing (30%). Among the strengths and opportunities, the regulatory framework and the Statutory Health Law stand out. It is concluded that, despite the achievements, the health system has difficulties and situations to be solve, such as corruption, showing weak governance. The lack of appropriate and effective bodies or spaces for discussion, coordination and decision-making is notorious, in order to guarantee the right to health. Aunque la gobernanza en salud puede traer beneficios, como un mayor gasto público, el control de la corrupción, mayores niveles de participación y una mejor rectoría, no existe una noción unificada del término ni de los procesos asociados. El objetivo de esta investigación es conocer la mirada de los actores sobre la gobernanza del sistema de salud colombiano. Para eso, se realiza un estudio cualitativo basado en la aplicación de una encuesta con preguntas estructuradas y abiertas a 141 líderes del sistema de salud, bajo un muestreo no probabilístico por conveniencia. Del análisis resulta que el conocimiento del término gobernanza es bajo. La gobernanza es calificada en un nivel bajo (2,5/5,0) al igual que sus funciones clave (2,6), siendo la participación ciudadana, la transparencia y la rendición de cuentas las que fueron peor calificadas. Además, falta conocimiento de la Instancia de Coordinación y Asesoría y de la Comisión In