This article discusses the trends and limits of the Brazilian health system decentralization process, identifying the three elements that constitute the strategic induction performed by the national system administrator in accordance with the guidelines contained in the Operational Norms of the Unified National Health System: systemic rationality, intergovernmental and service provider financin...

The Chilean health care system has been intensively reformed in the past 20 years. Reforms under the Pinochet government (1973-1990) aimed mainly at the decentralization of the system and the development of a private sector. Decentralization involved both a deconcentration process and the devolution of primary health care to municipalities. The democratic governments after 1990 chose to preserv...

After 1949, the communist government under Mao Zedong built strong collective health care and public health systems. While mental health care did not receive specialized attention, the overall health of Chinese citizens was improved due to the emphasis on basic health care. Within thirty years, these Chinese systems became the envy of many developing (and developed) countries struggling to prov...

Background: The Ugandan Government has aimed at creating a needs-based and cost-effective health care system. The means to carry out this aim have been 1) a decentralization of the health sector in order to increase lower-level responsibility, accountability, and participation, and 2) a strong national policy formulation capacity, facilitating needs assessment and cost-effective prioritization....

Spain’s Transition to Democracy set the stage for the organization of a national healthcare system. The adoption of the Spanish Constitution of 1978 was a political milestone that led to the recognition of every citizen’s right to healthcare and the right of autonomy of the various regions that make up the Spanish State. The most distinctive characteristic of the healthcare model set up in thos...

Health authorities in developing countries must often cope with rapid changes in the administrative, policy and socioeconomic contexts in which they work. Changes in this external environment have important implications for the roles that health planners can effectively play and the leverage they exercise throughout the system. This paper examines the challenges associated with reorienting mini...

A shift towards decentralization in many low-income countries has meant more skills are demanded of primary health care managers, including data and information handling at all levels of the health care system. Ministries of Health are changing their central reporting health information systems to health management information systems with emphasis on managers utilizing information at the point...

The underlying vision for health developments and reforms in Kenya as detailed in the ongoing 1994 Kenya Health Policy Framework Paper is to provide “quality health care that is acceptable, affordable and accessible to all”. This paper discusses the reforms in the healthcare policy in Kenya by evaluating the health sector developments in the post-colonial era. Key issues, trends, challenges and...

Corruption is defined in an occupational choice model as extra fees that must be paid by some entrepreneurs. Higher corruption leads to lower wages and total output. Income inequality follows a Kuznets relationship with both corruption and income. Two types of decentralization of the bribe-setters are distinguished, regional and bureaucratic. When mobility is imperfect, bureaucratic decentraliz...