Factors influencing national public health governance capacity: based on NCA and fsQCA

Introduction With the acceleration of globalization, a series of public health emergencies have not only threatened population health but also significantly impacted global economic and political stability, highlighting the urgency for effective public health governance. Methods This study employs the TOE framework to examine 149 countries as case studies, utilizing Necessary Condition Analysis (NCA) and fuzzy-set Qualitative Comparative Analysis (fsQCA) to investigate the interactive effects and pathway selections of technological, organizational, and environmental conditions on national public health governance capacity. Results The findings reveal the following: (1) No single factor constitutes a necessary condition for high-level public health governance capacity. (2) Technological, organizational, and environmental factors operate in complex “multiple concurrent” configurations, generating diverse pathways that drive national public health governance capacity, illustrating the princi