Hoellwarth concedes that it might be possible to develop effective oversight protocols or other systems to rein in some of this confusion and frustration over time.
Indeed, for many of these successes, domestic health stewardship allowed effective oversight, performance monitoring, coalition building, system design, and accountability.
WHO defines leadership and governance as the existence of a strategic policy framework as well as effective oversight, coalition building, regulation, attention to system design, and accountability [ 6].
The WHO definition of leadership and governance is the existence of a strategic policy framework as well as effective oversight, coalition building, regulation, attention to system design, and accountability [ 6].
According to WHO [ 16] stewardship involves ensuring strategic policy frameworks exist and are combined with effective oversight, coalition building, regulation, attention to system-design and accountability.
Here, governance was proposed as "ensuring that strategic policy frameworks exist and are combined with effective oversight, coalition building, regulation, attention to system-design and accountability".
The World Health Organization (2007, p. 3) defines health system governance as a national function entailing that 'ensuring strategic frameworks exist and are combined with effective oversight, coalition-building, the provision of appropriate regulations and incentives, attention to system design and accountability'.
Without effective oversight by an independent agency, states frequently rely on a system of self-reporting.
"In a universe where corrupt politicians are seldom removed from office, there are few institutional incentives for effective oversight and punishment," said Matthew Taylor, an expert on Brazil's legal system at American University in Washington.
Thus, we believe it is important that the legislation reauthorizing PRIIA should require Metro to implement measures that will lead to effective oversight and strong accountability within a highly complex and often nontransparent multi-jurisdictional system.
