 This paper proposes a comprehensive framework for assessing the governance capacities of ministries of health, MOSE, in low and middle income countries, MIX. It examines the hard and soft dimensions of governance, which include de jure, de facto, tacit, and relational capacities. The authors argue that these capacities must be considered together in order to capture the full range of capabilities required for effective governance. They also provide 4K's studies to demonstrate how this framework can be applied in practice. Ultimately, they hope that this framework will help identify areas where MOSE need additional support or resources, and guide strategies to strengthen their governance capacities. This article was authored by Kabir Sheikh, Veena Shriram, Benjamin Rufi, and others.