background in early 1990s, tanzania like other african countries, adopted health sector reform (hsr). the most strongly held centralisation system that informed the nature of services provision including health was, thus, disintegrated giving rise to decentralisation system. it was within the realm of hsr process, user fees were introduced in the health sector. along with user fees, various typ...

Health care system reform covers a disparate and controversial array of issues, a characteristic apparent in the related literature. The literature on proposed system reforms appears to be strongly driven by the actual public policy environment in Washington. Many articles discussing tax credits and reform proposals constructed using tax credits were published during the time when the Bush Admi...

This paper reviews Latin American neoliberal health reforms sponsored by the IMF and the World Bank, and analyzes the impact on the region of decentralization and privatization, the two basic components of the reforms. The second part of the paper examines in some detail the Chilean and Colombian reforms, the two countries that have implemented closely the principles of the neoliberal reform. T...

in 2010, the united states adopted its first-ever comprehensive set of health system reforms in the affordable care act (aca). implementation of the law, though politically contentious and controversial, has now reached a stage where reversal of most elements of the law is no longer feasible. the controversial portions of the law that expand affordable health insurance coverage to most u.s. cit...

BACKGROUND In 1995 Saskatchewan adopted a district health board structure in which two-thirds of members are elected and the rest are appointed. This study examines the opinions of board members about health care reform and devolution of authority from the province to the health districts. METHODS All 357 members of Saskatchewan district health boards were surveyed in 1997; 275 (77%) responde...

Recognizing the advantages of primary care as a means of improving the entire health system, this text comments on reforms of publicly funded primary health centers, and the rapid development of private forprofit providers in Sweden. Many goals and expectations are connected to such reforms, which equally require critical analyses of scarce resources, professional trust/motivation and business ...

Unlike the managerially oriented reforms that have brought auditing and accounting into such prominence in the UK National Health Service (NHS), and which seem alien to the culture of the caring professions, consumerist reforms may seem to complement moves towards the acceptance of wide definitions of health, and towards increasing patient autonomy. The empowerment favoured by those who support...

The Mexican health system has evolved through three generations of reform. The creation of the Ministry of Health and the main social security agency in 1943 marked the first generation of health reforms. In the late 1970s, a second generation of reforms was launched around the primary health-care model. Third-generation reforms favour systemic changes to reorganise the system through the horiz...