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Bellagio Meeting - Day Three

Commonalities emerging from the multi-level reflection

On Day Three the group engaged in a critical deconstruction of the multi-level governance arrangements proposed during the group work on Day Two. The main outcome of this deconstruction exercise was the emergence of strong commonalities:


- A common sense of purpose between all three levels, from local to national and global levels

- A common understanding that the status quo and current ways of operating must radically change

- Acknowledgment of power dynamics

- The need to foster diversity and multiplicity of actors

- The need to seed change for transformation


Way forward


After three days of collective reflection, the group spent the last hours of the meeting designing an inclusive path forward, identifying different products and related collaborations which will emanate from this week in Bellagio. The general objective will be to bring the health sector back into the wider governance debate and to build tools for positive change at all levels and in all settings. Most of the work from this point on will be supported by the Collaborative web-platform which will allow our wider community to engage in the process.


Moving forward, one of the first issues that struck the group was the lack of a common language in Governance, as the one that has been built in recent years in fields like health financing. To address that problem it has been decided that the first item will be the co-construction of a glossary for governance, building on the existing literature, to ensure that in future dialogue all stakeholders will share a common understanding of terminologies and concepts. Such glossary will need to be developed in different languages (and avoid the usual translation of an English language glossary in other languages, as the concepts will need to be captured precisely).


The second collaborative product will be an overarching conceptual paper on actionable governance starting from the discussions the group had this week and developing the commonalities identified above.


Third, the group will reach out and engage in a number of deep dives: these will explore actionable governance at local, national and global level and across the three levels. Deep dives will illustrate the applications of actionable governance and can use case studies and stories documented on different types of media.  


The Collaborative interactive webplatform will be used to develop an e-learning program on health systems governance, based on the material developed above.


A set of practical tools and guides to face day-to-day governance issues, specially designed to help governance non-specialists will form the fifth product.


Finally, the sixth objective will be to work on a broader dissemination of all co-constructed knowledge, using among other vehicles policy briefs and simplified messages for non governance specialists.


The group decided to reconvene during the Health Systems Research Symposium in Liverpool in October 2018. From Bellagio to Liverpool, the objective will be to develop initial drafts of products 1, 2 and 3. The secretariat of the Collaborative will organise the logistics and communications for this work to take place. This period of time will also be an opportunity to engage a wider group of stakeholders in collaborations around these products.


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