In 1987, district health care policies were officially adopted by a majority of developing countries. Many operational problems constraining implementation of such policies have subsequently been identified, most of which are attributable to well-known characteristics of less developed countries. However, the policy of operational and administrative decentralization has often been critically ob...

Integrated health systems are confronted with numerous dilemmas that must be managed. Many of these dilemmas are an inherent part of the system's structure, given that multiple competing hospitals, medical groups, and (sometimes) health plans are often under one organizational roof. This article presents an analysis of these dilemmas--referred to in the management literature as polarities--as t...

We congratulate Duncombe and colleagues for their interesting review concerning the role of the geographic information system (GIS) for dengue surveillance. They provide examples, particularly from the developing countries, showing the various functions of GIS to automate spatial identification, visualization, analysis, and decision making aiming to assist dengue-related public health actions. ...

Background In 2004, the health system in Iran initiated an organizational reform aiming to increase the autonomy of teaching hospitals and make them more decentralized. The policy led to the formation of a board of trustees in each hospital and significant modifications in hospitals’ financing. Since the reform aimed to improve its predecessor policy (implementation of hospital autonomy began i...

This paper presents different models that describe health determinants, services, and systems. It highlights the important model developed by Contandriopoulos, proposing a separation between the health status and health care circuits. The article is intended as a contribution to the field of comparative analysis with a new theoretical, methodological, and evaluative approach. Problems were iden...