title: A survey of the governance capacity of national public health associations to enhance population health.
abstract: BACKGROUND
  National public health associations (PHAs) are key partners with governments and communities to improve, protect and promote the public's health. Governance and organizational capacity are among the key determinants of a PHA's effectiveness as an advocate for appropriate public health policies and practice.
  
  
  METHODS
  During 2014, the World Federation of Public Health Associations (WFPHA) conducted an on-line survey of its 82 PHA members, to identify the state of organizational governance of national public health associations, as well as the factors that influence optimal organizational governance. The survey consisted of 13 questions and focused on the main elements of organizational governance: cultivating accountability; engaging stakeholders; setting shared direction; stewarding resources; and, continuous governance enhancement. Four questions included a qualitative open-ended response for additional comments. The survey data were analyzed using Microsoft Excel. The qualitative data was analyzed using thematic content analysis
  
  
  RESULTS
  Responses were received from 62 PHAs, constituting a 75.6 % response rate. The two most important factors that support governance effectiveness were a high degree of integrity and ethical behavior of the PHA's leaders (77 %) and the competence of people serving on the PHA's governing body (76 %). The lack of financial resources was considered as the most important factor that negatively affected organizational governance effectiveness (73 %). The lack of mentoring for future PHA leaders; ineffective or incompetent leadership; lack of understanding about good governance practices; and lack of accurate information for strategic planning were identified as factors influencing PHA governance effectiveness. Critical elements for PHA sustainability included diversity, gender-responsiveness and inclusive governance practices, and strategies to build the future generation of public health leaders.
  
  
  CONCLUSIONS
  National PHA have a responsibility to put into place the practices and infrastructure that enhance organizational governance. This will enhance their ability to be effective advocates for policies and practices that enhance, protect and promote the public's health. The WFPHA has an important role to play in providing the technical assistance and financial resources to assist PHAs in attaining and sustaining a higher level of governance capacity.
authors.affiliation: World Federation of Public Health Associations, c/o Institute of Global Health, University of Geneva, Biocampus - B304, chemin des Mines 9, 1202, Geneva, Switzerland. james.chauvin@wfpha.org.
authors.forename: James
authors.initials: J
authors.lastname: Chauvin
authors.affiliation: Management Sciences for Health, Medford, Massachusetts, USA.
authors.forename: Mahesh
authors.initials: M
authors.lastname: Shukla
authors.affiliation: Management Sciences for Health, Medford, Massachusetts, USA.
authors.forename: James
authors.initials: J
authors.lastname: Rice
authors.affiliation: Centre for Health Policy & Medical Research Council Health Policy Research Group, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Rispel
mesh_terms: D057191:Capacity Building; D006076:Government; D006295:Health Resources; D006801:Humans; D007857:Leadership; D011634:Public Health; D011635:Public Health Administration; D012941:Social Responsibility; D011795:Surveys and Questionnaires
keywords: Capacity building; Governance; Organizational capacity; Organizational governance; Public health association; World Federation