Recent policy developments in public health care systems lead to a greater diversity in health care. Decentralization, either geographically or at an institutional level, is the key force, because it encourages innovation and local initiatives in health care provision. The devolution of responsibilities allows for a sort of 'deconstruction' of the status quo by changing both organizational form...

Policies to reform health care provision often combine the organizational restructuring of decentralization with ideological restructuring through a new model of health care that gives greater weight to prevention and promotion. Decentralization provides a discretionary space to the local health system to define and develop its own activities. The central policy aim to shift the model of health...

for more than three decades healthcare decentralization has been promoted in developing countries as a way of improving the financing and delivery of public healthcare. decision autonomy under healthcare decentralization would determine the role and scope of responsibility of local authorities. jalal mohammed, nicola north, and toni ashton analyze decision autonomy within decentralized services...

This paper reviews the progress of implementation of health-care decentralization in Thailand since the promulgation of the Decentralization Act 1999, draws lessons learnt and provides recommendations. This review was carried out because of the delay in health-care decentralization, as compared with what was indicated in the Decentralization Action Plan, and to identify the possible causes of d...

BACKGROUND In India, the process of decentralization of health services started taking shape in the mid-1990s. Systemic reforms envisaged delegation of administrative and financial responsibilities at district level for management of health-care institutions in 23 states of India in 1999. Subsequently, some of these reforms became part of the National Rural Health Mission (NRHM) launched in 200...

vii 1. Why Should We Worry about Decentralization? 1 2. Decentralization: A Complex Phenomenon 4 Why Is Decentralization Happening? 4 What Is Decentralization? 4 What Are the Implications of Decentralization? 6 Successful Decentralization Depends on Institution-Specific Design 7 3. Designing Decentralization: The Building Blocks of Fiscal Federalism 10 Assigning Expenditure Responsibilities 10 ...