Abstract Health governance – one of the pillars of a health system – has received appreciable attention from the Ethiopian health sector over the past decade. Through the leadership of the Federal Ministry of Health (FMOH), the health sector has various coordinating mechanisms at the federal, regional, and woreda (district) levels, although the performance of the coordinating mechanisms weakens as one goes from the federal to the woreda level. To make facilities responsive to local needs and mitigate administrative complexities, the government initiated health facility governance reform by introducing boards for hospitals and governing bodies/management committees for health centers. Boards are now well established in most health facilities. They facilitate linkage with the community, and are used to advocate for increased resource mobilization for facilities. In addition, these governance structures serve as the major monitoring and decisionmaking bodies, and currently all reform efforts, including health care financing, very much depend on their functioning…..more