Challenges in Public Health Governance: The Canadian Experience is an examination of public health from a governance perspective. Part 1 begins with an examination of the fragmented nature of public health in Canada, identifies some major fault lines that characterize the public health realm, and reviews briefly the notion of network governance. Part 2 looks at specific public health theatres: crisis issues such as SARS and the HlNl pandemic, and the ongoing work of the Canadian Heart Health Initiative. It also examines the Pan-Canadian Public Health Network as the key piece of network infrastructure at the national level.
It seeks to demonstrate that current governance structures and mechanisms are inadequate to deal with the governance challenges facing public health, and that network governance, appropriately applied, is a means through which public health in Canada can better achieve its objectives. Part 3 examines the nature of the relationships with the voluntary sector and discovers that much of the potential of these organizations to contribute to public health is being lost.
Introduction – Governance, networks and public health
Part I – Setting the Stage
Chapter 1 – Public health and fragmentation: Three fault lines
The length and breadth of public health
Three major fault lines
Chapter 2 – Looking ahead: Is network governance ‘the answer?’
Network governance – what is it?
The need for ‘entanglement strategies’
Weighing the costs and benefits
Conclusion: Applying network governance to public health
Part II – Public health governance in Canada: Three theatres
Chapter 3 – Governance and the public health network: Too much or not enough?
The Pan-Canadian Public Health Network (2005 edition)
The PNH (2005): A breakthrough towards network governance?
The 2011 Operational Review
The PNH (2011 edition): Increased efficiency, but at what price?
Chapter 4 – Governance in ‘war time’: Networks and public health emergencies
Brief review of SARS events
Flawed governance prescriptions in post-SARS literature
Can network governance be applied to emergencies?
Emergency preparedness and response in the Canadian context
The H1N1 pandemic in Canada: What did this reveal^
Chapter 5 – Governance in ‘peace-time’: The case of the Canadian Heart Health Initiative
The Canadian Heart Health Initiative
Part III – Expanding the Base
Chapter 6 – The voluntary sector in public health governance
The voluntary sector: Terminology and context
The voluntary sector in Canada
What makes the public health voluntary sector special?
Three types of government-VSO relationships
Conclusion: A base to build on?
Chapter 7 – Global Drivers
Westphalia and beyond
From international health governance (IHG) to global health governance (GHG)
The drive for collaborative mechanisms
Conclusion: Implications for Canada
Part IV – Developing the Tools
Chapter 8 – Facing the tough questions
Network governance and the ‘governability’ question
Accountability, transparency and legitimacy
Operating in the ‘shadow of hierarchy’
Chapter 9 – Towards a Network Governance Regime in Public Health
Where to from here?