Decentralising urban health activities in developing countries

The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand, or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material. While there is considerable documented experience of decentralismg health services in ru, ral areas of developing countries, the decentraIisation of health services in the urban context is rarely analysed. Urban development literature usually fails to address bealtb issues, while the literature on the decentralisation of bealth services tends to ignore tbe urban sector. This article addresses the relationship between a Ministry of Health and a City Council, and ident~'es key issues to consider in the decentralisation of urban health activities: roles and responsibilities; legislation; coordination and communication; and resource constraints. The case-study from Maseru, Lesotho, highlights aspects of planning which need to be considered by national and loca ! governments which are trying to strengthen urban health activities by decentralisation.