Abstract Recent work on health system strengthening suggests that a combination of leadership and policy capacity is essential to achieve transformation and improvement. Policy capacity and leadership are mutually constitutive but difficult to assemble in a coherent and consistent way. Our paper relies on the nested model of policy capacity to empirically explore how health reformers in seven Canadian provinces address the question of policy capacity. More specifically, we look at emerging representations of policy capacity within the context of health reforms between 1990 and 2020. Based on the exploration of the scientific and grey literature (legislation, annual reports of Ministries, agencies and organizations, meeting minutes, press, etc.) and interviews with key informants (n = 54), we identify how policy capacity is considered and framed within health reforms A series of core dilemmas emerge from attempts by each province to develop policy capacity for and through health reforms.

中文翻译：

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卫生改革和政策能力：加拿大的经验

摘要 最近关于加强卫生系统的工作表明，领导能力和政策能力的结合对于实现转型和改进至关重要。政策能力和领导力是相辅相成的，但很难以连贯一致的方式组合起来。我们的论文依靠政策能力的嵌套模型来实证探索加拿大七个省份的医疗改革者如何解决政策能力问题。更具体地说，我们着眼于 1990 年至 2020 年医疗改革背景下政策能力的新兴表现形式。基于对科学和灰色文献（立法、部委、机构和组织的年度报告、会议纪要、新闻等）的探索.) 和关键信息提供者的访谈 (n = 54)，