Leadership and governance is a building block of the health system that involves provision of strategic policy frameworks and effective oversight, coalition-building, regulation, and accountability. While leadership entails inspiring and motivating teams towards shared goals, embodying integrity, and fostering a culture of innovation and collaboration, governance is a cross-cutting theme, intimately connected with issues surrounding accountability. The growing demand to demonstrate results from health investments thus necessitates greater accountability.

Together, these components cultivate resilience, agility, and excellence, positioning the health system to navigate complexities, adapt to change, and achieve sustainable impact. However, despite the importance of leadership and governance in improving health and health system outcomes, the building block is yet to receive adequate attention in monitoring and evaluation.