02 Bossert (JG/d)
نویسندگان
چکیده
In the last two decades, health sector decentralization policies have been implemented on a broad scale throughout the developing world, usually as part of a broader process of political, economic and technical reform (Litvack et al. 1998). This process has been fuelled by new efforts of democratization and processes for the ‘modernization’ of the state. These movements combined to promote accountability to local preferences, as well as to introduce competition and costconsciousness into the public sector and develop a new role for the state in ‘enabling’ and regulating rather than replacing private sector activities. In the health sector, this initiative has been reinforced by many donor supported projects of USAID and other bilateral agencies, as well as multilaterals like the World Bank, regional international banks, WHO, PAHO and UNICEF. The movement for health reform, including an emphasis on decentralization, was promoted actively in the World Development Report 1993: Investing in Health (World Bank 1993).
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