Decentralizing Health: Lessons from Indonesia, the Philippines, and Vietnam

ence of three East Asian countries from the perspective of how well they have addressed the special features and requirements of the health sector. These features include the substantial role of externalities, the high degree of specialization, the critical role of quality and timeliness, and the high level of knowledge required to participate in the health care system at all levels. These characteristics have important implications for the design of health policy in general, and especially for a decentralized system of service delivery and sector management. This chapter outlines the decentralization health policies and programs of Indonesia, the Philippines, and Vietnam, focusing on the period 1985–2003, spanning the years before and after significant decentralization began in these countries. The chapter also points to areas where reforms may facilitate more effective health care delivery.