Vignettes to analyse health systems and stewardship: prospects, challenges and the limits of governability

The role and involvement of the state in the functioning and performance of the health system have been an area of debate and discussion for many years. The extent to which governments are intrinsically involved in the various aspects of the health system varies significantly. This variability in the role and involvement of the state is dependent on and influenced by a variety of elements. Such elements include the country's level of economic and social development, historical or legacy factors, and the legal obligations placed on the state to ensure that its citizens have access to acceptable health services.