The aim of this paper is to gather elements for a discussion on health policies and services in northeast Brazil. The author begins with an analysis of the population's main health problems, the health system's limitations, and current opportunities for implementing health programs. She highlights the following research priorities: people's health situations according to their material living c...

Nepal moved from unitary system with a three-level federal system of government. As federalism accelerates, the national health system can also speed up its own decentralization process, reduce disparities in access, and improve health outcomes. The turn towards federalism creates several potential opportunities for the national healthcare system. This is because decision making has been devolv...

Using panel data for a maximum of 109 countries over the years 1976-2000, we empirically analyze the impact of decentralization on the occurrence of transnational terror. Our results show that expenditure decentralization robustly reduces the number of terror events in a country, while political decentralization has no impact. The effects of decentralization do not transmit through government e...

This paper provides evidence on the effectiveness of centralized and decentralized health care organizations in the developing world. It compares performance by taking advantage of health care provider duplication in rural Mexico. The analysis benefits from differences in timing and models of health care decentralization, and from a quasi-random distribution of providers. In contrast with the m...

Many countries in Africa have embarked on health sector reforms. The design of the reforms differs considerably. A key feature of the reforms is decentralization, of which Uganda and Zambia are implementing two different models. This paper analyses the two models of health sector reform, and their implications for ultimate development goals. In Uganda, the whole government has been decentralize...

BACKGROUND Decentralization of ART services scaled up significantly with the country wide roll out of option B plus in Uganda. Little work has been undertaken to examine population level access to HIV care particularly in hard to reach areas in rural Africa. Most work on ART scale up has been done at health facility level which omits people not accessing healthcare in the community. This study ...

Decentralization has dramatically altered governance in developing countries. However, the empirical evidence on its welfare effects has been limited and ambiguous. I argue that this ambiguity is due to a misidentification of different types of decentralization – namely administrative, political and fiscal – and their synergies. In order to test this claim, the paper employs a unique Indonesian...

Debates about decentralization raise cultural questions of identity and economic questions of redistribution and efficiency. Therefore the preferences of statewide parties regarding decentralization are related to their positions on the economic and cultural ideological dimensions. A statistical analysis using data from thirty-one countries confirms this: parties on the economic right are more ...

The typical post-Bretton-Woods era development approach that puts great emphasis on central government efforts to promote development, has changed dramatically and local governments have now emerged as important players in development policy. Now, the concept of requirements for achieving the development objectives is changing and many countries around the world are now implementing fiscal dece...