The complex ways in which decentralization is practised in the ®eld of government health services are examined. Organizationally, decentralization means a choice between different types of public institution, which vary in terms of: the areas over which they have jurisdiction, the functions delegated to local institutions; and the way decision-makers are recruited, so producing institutions. Th...

In 1991, Indonesia began a process of decentralization in the health sector which had implications for the country's public hospitals. The public hospitals were given greater authority to manage their own personnel, finance and procurement, with which they were allowed to operate commercial sections in addition to offering public services. These public services are subsidized by the government,...

This commentary reviews contemporary changes in aid modalities and their impact on processes of decentralization. The main change in aid delivery and disbursement considered is towards a greater emphasis on general budget support (GBS) and sector wide approaches (SWAPs). This includes considering the broad questions of firstly, the impact of emphasising GBS on local government and governance sy...

This paper highlights key considerations for policymakers in ministries of health and decision makers from the international donor community for prioritizing supply chain management throughout the health reform process—primarily when decentralizing and/or integrating the public health system. From a thorough compilation of experiences in the Latin American and Caribbean region, this paper synth...

How does the degree of political decentralization in a country affect the quality of its government? Greater political decentralization might make governments more honest and efficient by bringing officials “closer to the people”, forcing them to compete for mobile capital, and facilitating the satisfaction of diverse local tastes. On the other hand, it might create coordination problems or roa...

This paper focuses on the balance between central governmental control, autonomy for health care institutions and (quasi)-market mechanisms by examining recent health care reforms in Norway, Denmark and United Kingdom. The reforms involve strengthening of overall central government control, simultaneously representing a decentralized system of management and business-like mechanisms to ensure p...

1 Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia, 2 UNICEF Office for China, Beijing, People’s Republic of China, 3 Department of Health Policy and Administration, School of Public Health, Peking University, Beijing, People’s Republic of China, 4 Department of Health Statistics and Social Medicine, Fudan University School of Public Health, Shanghai, People’s R...

BACKGROUND Throughout the economic and political reforms in post-communist countries, significant changes have also occurred in public morality. One of the tasks of the Lithuanian health policy is to create mechanisms for strengthening the significance of ethical considerations in the decision-making processes concerning health care of individuals and groups of individuals, as well as consideri...