تحلیل پیامدهای تمرکززدایی سیستم سلامت بر حاکمیت و عدالت در سلامت: به روزرسانی مطالعات مرور منظم

Introduction: One of the goals of health systems is to reduce inequality in access to care and promote people's health. Decentralization in the past four decades has aimed at improving management processes and providing appropriate services. The purpose of this study was to investigate the consequences of decentralization by updating systematic review studies. Materials and Methods:  This research is the result of updating the last studies on systematic review of health system's decentralization (March 2016). For this research, all original research papers on the topic were collected by searching in valid databases and qualitative evaluation was performed after removing duplicate and non-related ones. Results:  Out of the 640 founded papers, seven  study were selected.Decentralization in countries with an organizational structure and appropriate local capacity improves the Governance and active participation of the community, trusts decentralized care, reducing travel distances, increasing access to treatment, achieves universal coverage, and improves all important parameters of service delivery, including quality. It also increase annual visits and reduces infant mortality that can improve access to equity and health outcomes. Conclusion: Decentralization provides an opportunity for community and employee participation in planning, budgeting and providing of justice in resource allocation, and thereby motivates and improves the quality of service delivery. Given that the decentralization implementation in each country depends on the political leadership, socio-economic background, pre-implementation infrastructure and managerial and technical skills at the local level, therefore, key health sector policy makers should have a deep understanding of the country's context in designing and implementing technical strategies.