Government Restructuring and Revitalization: A Strategic Roadmap to Modernize the State and Improve Population Health and Well-Being
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Abstract
Introduction: This article develops the second pillar of the tripartite strategy presented in “A Presidential Vision for Guatemala Grounded in the Social Determinants of Health.” It presents the restructuring and revitalization of the State as a strategic public health intervention, vital for transforming institutions. Objectives: analyze structural causes and institutional barriers that limit sustainable health development, and propose a model that increases governmental efficiency, effectiveness, and equity. Methods: a qualitative design of conceptual analysis and synthesis was employed, with an inductive, deductive, historical, and ecological approach, to identify structural and systemic patterns of institutional weakness and, drawing on international benchmarks, build a contextualized operational framework for health and national governance. Results: to improve the health and well-being of the population, a Government Restructuring and Revitalization model is proposed to modernize public administration through three interdependent strategic goals with a transformative vision, nine key objectives representing intermediate outcomes, and twenty-seven priority strategies constituting actionable interventions, organized in a 3x3x3 Matrix. The model articulates the modernization of government capacities, programmatic innovation, and the generation of national impact. It reframes governmental restructuring as a public health intervention to address social determinants that perpetuate exclusion, inefficiency, and inequity. Conclusions: This study establishes that governmental restructuring—understood as the redefinition of structures, processes, and functions—and institutional revitalization—aimed at strengthening capacities, motivations, and performance—are indispensable conditions to overcome the status quo and achieve sustainable reforms that improve the health and well-being of the population.
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