Initiatives > Fund management > How is governance for these funds structured? >

Model 3: A unit within the government structure

Traditionally, public health and health promotion policy is located in ministries of health. In reality, it can be set up and managed by any government department but should be accountable and responsible to the Prime Minister or the Ministry of Health. This type of governance model may result in less flexibility for innovative and more controversial programmes, particularly if some government members are unsupportive of initiatives.

As a government entity, the main goal is supporting the implementation of government public health policies and strategies in close collaboration with other government sectors. A potential advantage is easier access to other government departments through the relevant Minister and or Departmental Head. By accessing a range of expertise from across government departments and developing strong working relationships, greater coordination can be fostered and the potential for duplication of resources, funding or efforts reduced. The nested nature of this type of entity; however, may inhibit its ability to collaborate with civil society and non-government agencies as well as some parts of the private sector.

The discrete unit is likely to be exposed to administrative and government influence, particularly in the making of policies and setting of priorities for health promotion. Also the decision-making process for the disbursement of grants and sponsorships may be more readily influenced than if it was an autonomous entity. 

The sources of funding can be the same as for an autonomous entity. However, if collection of funds is handled within the government system in the absence of an independent board to oversee the distribution of funds, there is a high potential for ministerial and legislative redirection of funds to other priorities.

Advantages

  • Fully support and implement government public health policies, priorities, and strategies because of the close working relationship with other areas within the department 
  • Gain direct access to government through the Minister and Departmental Head to better influence policy and direction for health promotion. 
  • Reduce potential for duplication of funding or effort. 
  • Access resources and expertise from a range of other departmental units. 

Disadvantages

  • Reduced independence because of direct ministerial control; limited flexibility to undertake innovative and perhaps controversial programmes and activities.
  • Possibility of political influence in grants and sponsorship disbursement decisions.
  • Potential competition from within the department for resources. 
  • Capacity may be limited by the bureaucratic requirements of a government department, thus affecting the ability of the unit to collaborate with other ministries and especially with other sectors outside of the government to respond quickly to emerging health issues or to provide grants in a timely manner. 

Case studies

Read more