# Establish or Define Governance Structures

## <img src="https://3308277642-files.gitbook.io/~/files/v0/b/gitbook-legacy-files/o/assets%2F-MaFTi2cXYF3MOUIP8lR%2F-MdXpu1aMJmDJvBtb41V%2F-MdXqvpJkWYJwVxndxcu%2Fcompany.svg?alt=media&#x26;token=53906fd0-f1ed-40ea-abf1-f7a574b25ffb" alt="" data-size="line"> **Establish or Define Governance Structures**                                                                                &#x20;

There is often a tendency to consult stakeholders and governance structures at the beginning and end discussions there.  Be careful to manage this pitfall as success of the project is often due to communication and buy-in from stakeholders and governance structures. If governance structures are already defined, clearly establish how the project team and stakeholders align and report to established governance groups.  \
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If governance structures are not already in place, the team will need to begin to establish some governance structure that will support definitions and maintain the health architecture.  Depending upon the scope of the architecture and the goals for getting started, the governance structure may need to consider engaging the following types of groups or groups that support these services:

* Government and / or Ministry of health ICT&#x20;
* Government and / or Ministry of health internet and technical infrastructure&#x20;
* Country standards groups boards or bodies&#x20;
* Government and / or Ministry of health cloud services or hosting services teams. &#x20;
* Private healthcare stakeholders or research organizations that may need to interact with MOH services and data
* Privacy and security officers or advisers&#x20;
* Country or regional identity managers&#x20;
* Civil registries&#x20;
* Health supply chains&#x20;

{% hint style="success" %} <img src="https://3308277642-files.gitbook.io/~/files/v0/b/gitbook-legacy-files/o/assets%2F-MaFTi2cXYF3MOUIP8lR%2F-Me6FCaymA0hPSnuCVe3%2F-Me6G6QqCYm4wLGJYCDm%2Fbook.png?alt=media&#x26;token=41c72f52-4856-49b2-a201-07e2ca52e137" alt="" data-size="line"> **References:**&#x20;

* [Digital Implementation Investment Guide](https://www.who.int/publications/i/item/9789240010567) (Chapter 6: Digital Health Architecture)&#x20;
* Nsaghurwe, A., Dwivedi, V., Ndesanjo, W. et al. [One country's journey to interoperability: Tanzania's experience developing and implementing a national health information exchange. BMC Med Inform Decis Mak 21, 139 (2021).](https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-021-01499-6)
  {% endhint %}


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