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Sound organisational governance does not occur naturally; it is a product of effective awareness. This study aims to examine the level of governance awareness among public hospitals' governance actors in Malawi.

The study uses semi-structured interviews to collect data that are analysed thematically.

The study found that governance awareness among the actors was low. Although the majority of the actors displayed a broad perspective, they, however, failed to clearly affirm the nexus of the governing organs – hospital board (or its equivalent) and hospital management. Furthermore, most were not aware of the existence of the country's self-regulatory framework for organisational governance. A possible compounding factor to the low level of awareness is their educational background that hardly recognises organisational governance as an essential component of their professional identity.

This is the first study to explore in-depth governance awareness in the context of public hospitals in developing countries. It highlights the need to develop strategies for creating effective governance awareness amongst the actors, which is often overlooked when carrying governance reforms.