A health system in any country performs instrumental functions of stewardship (oversight), creation of resources (investment and training), delivering services (provision), and financing (collecting, pooling and purchasing) [ 1].
However, our study was restricted to aspects of the functions of stewardship, creating and sustaining health inputs, and financing for health research.
Secondly, this study was restricted to the NHRS functions of stewardship, financing and creating and sustaining resources or health research inputs.
In particular, other evidence suggests the importance of strategically integrating research into the health system functions of stewardship and service delivery to ensure government support for research [ 18, 22, 23].
We cannot have the evidence that the national health policy-makers need to formulate appropriate health policies and take relevant action to strengthen national health systems without NHRS that adequately perform their functions of stewardship, creating and sustaining health research resources, producing and using research results, and health research financing [ 12, 20, 29, 30].
When no legitimate government exists, the function of stewardship may be pooled among multiple stakeholders, although effective coordination is essential [ 54].
We believe that the use of pragmatic indicators commended by TATFAR, that can be locally adapted, are a valuable means of providing assurance about the function of stewardship programmes at a national and local level.
Renaming and redefining the roles combined in ownership - and particularly separating the investment and stewardship functions - may sound boring.
Instead, WHO should be split in two, separating its technical and political stewardship functions into separate entities, with collaboration in areas of overlap.
Talking with boards is essential to institutional investors' stewardship functions, and engaging with institutional investors has become a focus of listed companies' communication strategies.
