Optimizing Ontario Health Teams (OHTs): insights from global public health governance

Purpose Primary healthcare serves as the first point of access to medical services for the general population. As newer primary healthcare systems emerge, they often take time to refine their governance structures to maximize population health outcomes aligned with the quadruple aim. This study aims to explore and share learnings on how governance structures influence the performance and success of primary healthcare systems in respect to Ontario, Canada. Design/methodology/approach We conducted an analysis of the governance structures of several successful healthcare systems around the world. The study focused on identifying core governance functions—such as priority setting, performance monitoring, and accountability—that contribute to the effectiveness of these systems. Findings Our analysis suggests that successful health systems are typically rooted in governance frameworks that emphasize clear priority setting, continuous performance monitoring, and mechanisms for accountability. These elements appear to be critical in enabling healthcare systems to achieve better population health outcomes. Originality/value This commentary contributes to the literature by synthesizing governance strategies from high-performing global health systems and offering targeted recommendations for developing primary healthcare systems. The findings provide practical guidance for policymakers seeking to enhance governance to meet the quadruple aim.