Table 1

Why, what and how we measure health systems drivers of women’s, children’s and adolescents’ health with a governance focus

Why we measure	What we measure		How we measure
Framing	Health systems drivers relevant to governance	Measurement variables	Research epistemologies, methodologies and methods	Research continuum
Lens: Service delivery Focus: Health conditions with effective interventions View of power: Technocratic Mode of governance: Hierarchical Implementation focus: Blueprints for what works	Policy mandate Coordination for continuity across levels and sectors Service delivery readiness User characteristics	Technical content of policies Management mechanisms: committees, review meetings, etc Inputs/resources (human resources for health, supplies, finances) User profile (literacy, gender, class, ethnicity, age)	Epistemology: Positivist Methods: Measuring adherence to recommended protocols (users and providers) Applying implementation checklists Analysing household, facility surveys or routine HMIS and system-generated data Ecological analysis of large datasets	Disciplines: Epidemiology, demography Approach: Replicable measurements that validate progress or highlight gaps Evidence: Cross-national data sets Disciplines: Multiple social science disciplines Approach: Context embedded research Reflective practice Evidence: Tacit and experiential knowledge
Lens: Societal Focus: People with rights View of power: Unidirectional/power over/zero-sum Co-produced/relational Mode of governance: Negotiating interests, enabling collaboration Implementation focus: Social processes/relationships	Macro: Political prioritisation Meso: Accountability dynamics Micro: Interpersonal dynamics supporting empowerment or marginalisation	Stakeholder positions and interests Participation/mobilisation Organisational cultures Transparency Credibility/trust Social capital and networks Social/informal norms Framing	Epistemology: Legal Pragmatic/constructivist Methodologies: Legal analysis Health policy and systems research Methods: Stakeholder analysis, political mapping Social network analysis Case study research
Lens: Systems Focus: Complexity View of power: Creative: disruptive/productive Mode of governance: Principles enabling emergence Implementation focus: Interventions and people interact and evolve overtime	Dis/equilibria Feedback loops Eventuality of change Emergence Path dependence	Diversity of actors, varying power, alignment and interests Contextual permeability Adaptive or learning capacities Tipping points and motivation for emergence and change	Epistemology: Constructivist Methodologies: Ethnography Participatory action research Systems modelling Methods: Hidden transcripts Causal loop diagrams

HMIS, health management and information systems.