Effective governance of the public health system includes the establishment of institutional arrangements and policies along with their continuous monitoring to ensure proper implementation. Apart from promoting good leadership, it also includes specific interventions such as building accountability in the system (e.g. performance appraisal, target setting and monitoring, social accountability, citizens’ charter); patient centric services (patient feedback, reducing out-of-pocket expenditure, improving the patient experience, grievance redressal); compliance with statutory norms (Acts and regulations) and ensuring robust clinical governance (adherence to SOPs and standard treatment guidelines, and MDSR/CDR).