Challenges in Public Health Governance: The Canadian Experience

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ISBN: 978-0-9877575-8-6
6X9” book, 262 pages, 500 copies in print,
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ISBN: 978-0-9877575-9-3
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Information about the author:


Claude M. Rocan

TABLE OF CONTENTS

PREFACE by Dr. Trevor Hancock

INTRODUCTION – GOVERNANCE, NETWORKS AND PUBLIC HEALTH 1

I – SETTING THE STAGE

CHAPTER 1 – PUBLIC HEALTH AND FRAGMENTATION: THREE FAULT LINES

• Introduction 13
• The length and breadth of public health 14
• Three major fault lines 16
• Conclusion 31

CHAPTER 2 – LOOKING AHEAD: IS NETWORK GOVERNANCE ‘THE ANSWER?’

• Introduction 33
• Network governance – what is it? 34
• The need for ‘entanglement strategies’ 38
• Weighing the costs and benefits 40
• Conclusion: Applying network governance to public health 42

II – PUBLIC HEALTH GOVERNANCE IN CANADA: THREE THEATRES

CHAPTER 3 – GOVERNANCE AND THE PUBLIC HEALTH NETWORK: TOO MUCH OR NOT ENOUGH?

• Introduction 47
• The Pan-Canadian Public Health Network (2005 edition) 48
• The PHN (2005): A breakthrough towards network governance? 52
• The 2011 Operational Review 59
• The PHN (2011 edition): Increased efficiency, but at what price? 63
• Conclusion 66

CHAPTER 4 – GOVERNANCE IN ‘WAR TIME’: NETWORKS AND PUBLIC HEALTH EMERGENCIES

• Introduction 69
• Brief review of the SARS events 71
• Flawed governance prescriptions in post-SARS literature 72
• Can network governance be applied to emergencies? 81
• Taking stock 88
• Emergency preparedness and response in the Canadian context 91
• The H1N1 pandemic in Canada: What did this reveal? 93
• Conclusion 98

CHAPTER 5 – GOVERNANCE IN ‘PEACE-TIME’: THE CASE OF THE CANADIAN HEART HEALTH INITIATIVE

• Introduction 101
• Analytical framework 102
• The Canadian Heart Health Initiative 104
• Starting conditions 107
• Institutional design 109
• Collaborative process 115
• Facilitative leadership 118
• Conclusion 120

III – EXPANDING THE BASE

CHAPTER 6 – THE VOLUNTARY SECTOR IN PUBLIC HEALTH GOVERNANCE: PARTNERS IN NAME ONLY?

• Introduction 125
• The voluntary sector: Terminology and context 126
• The voluntary sector in Canada 128
• What makes the public health voluntary sector special? 134
• Three types of government-VSO relationships 136
• Conclusion: A base to build on? 152

CHAPTER 7 – GLOBAL DRIVERS

• Introduction 157
• Westphalia and beyond 158
• From international health governance (IHG) to global health governance (GHG) 160
• The drive for collaborative mechanisms 175
• Conclusion: Implications for Canada 179

IV – DEVELOPING THE TOOLS

CHAPTER 8 – FACING THE TOUGH QUESTIONS

• Introduction 183
• Network governance and the ‘governability’ question 184
• Accountability, transparency and legitimacy 187
• Operating in the ‘shadow of hierarchy’ 191

CHAPTER 9 – TOWARDS A NETWORK GOVERNANCE REGIME IN PUBLIC HEALTH

• Introduction 195
• Where to from here? 196
• Conclusion 213

BIBLIOGRAPHY 217