Abstract

Kalonzo M. O and Mwai Richard Maatha

The objective of this paper is to understand the implementation of new modes and mechanisms of governance under Tunisia health reforms. Data were collected from a survey among a national sample of board members (N = 30). The analysis integrates findings from both the qualitative and quantitative data related to modes and mechanisms of governance. The results indicate a transition of the functions given to the hospital board from a model with professional and autonomous boards towards two different functions. They are a mixture between the tasks of a formal decision body and the behaviour of a body to secure the interests of different stakeholders. The findings suggest also that the board of directors in hospitals must act in a context of uncertainty and ambiguity. Political (contractual incentives and control systems) and cultural requirements and trusting relationships are beneficial to improve the current practices.