decentralisation continues to re-appear in health system reform across the world. evaluation of these reforms reveals how research on decentralisation continues to evolve. in this paper, we examine the theoretical foundations and empirical references which underpin current approaches to studying decentralisation in health systems.

Background The concept of decision space holds appeal as an approach to disaggregating the elements that may influence decision-making in decentralized systems. This narrative review aims to explore the functioning of decision space and the factors that influence decision space.   Methods A narrative review of the literature was conducted with searches of online databases and academic journals ...

background decentralisation aims to bring services closer to the community and has been advocated in the health sector to improve quality, access and equity, and to empower local agencies, increase innovation and efficiency and bring healthcare and decision-making as close as possible to where people live and work. fiji has attempted two approaches to decentralisation. the current approach refl...

decentralisation has been described as an empty concept that lacks clarity. yet there is an enduring interest in the process of decentralisation within health systems and public services more generally. many claims about the benefits of decentralisation are not supported by evidence. it may be useful as an organising framework for analysis of health systems but in this context it lacks conceptu...

Background Decentralisation aims to bring services closer to the community and has been advocated in the health sector to improve quality, access and equity, and to empower local agencies, increase innovation and efficiency and bring healthcare and decision-making as close as possible to where people live and work. Fiji has attempted two approaches to decentralisation. The current approach refl...

mohammed, north, and ashton find that decentralization in fiji shifted health-sector workloads from tertiary hospitals to peripheral health centres, but with little transfer of administrative authority from the centre. decisionmaking in five functional areas analysed remains highly centralized. they surmise that the benefits of decentralization in terms of services and outcomes will be limited....

Background Decentralisation in the health sector has been promoted in low- and middle-income countries (LMICs) for many years. Inherently, decentralisation grants decision-making space to local level authorities over different functions such as: finance, human resources, service organization, and governance. However, there is paucity of studies which have assessed the actual use of decisi...

Mohammed, North, and Ashton find that decentralization in Fiji shifted health-sector workloads from tertiary hospitals to peripheral health centres, but with little transfer of administrative authority from the centre. Decisionmaking in five functional areas analysed remains highly centralized. They surmise that the benefits of decentralization in terms of services and outcomes will be limited....

Decentralisation continues to re-appear in health system reform across the world. Evaluation of these reforms reveals how research on decentralisation continues to evolve. In this paper, we examine the theoretical foundations and empirical references which underpin current approaches to studying decentralisation in health systems.

the study of decentralization in fiji shows that increasing capacities is not necessarily related to increasing decision space of local officials, which is in contrast with earlier studies in pakistan. future studies should address the relationship among decision space, capacities, and health system performance.