Dr Saltman has tried with his article to forecast a trend for the future development of health policy in Europe, a very difficult task. His analysis concludes that there is a new re-centralization in countries where decentralization has been the paradigm in healthcare policy. Although this is very interesting, I do not totally agree. In my comment to this article, I will review the evidence of ...

D is pursued for a variety of reasons: technical, political, and financial. On the technical side, it is frequently recommended as a means to improve administrative and service delivery effectiveness. Politically, decentralization usually seeks to increase local participation and autonomy, redistribute power, and reduce ethnic and/or regional tensions. On the financial side, decentralization is...

OBJECTIVES This article presents an overview of the Spanish health sector variables and drug policies as well as highlights the perspectives of new reforms. METHODS Initially, the text frames the health sector in the sociodemographic context; it describes the past two decades of demographic changes noting particularly the very low birth rate and the growth in the proportion of the elderly. It...

BACKGROUND In East Wollega Zone, despite the success in creating considerable number of health facilities, short-age of health personnel, geographical imbalance and increasing attrition is found to be a persistent barrier to the effectiveness of the health system. However, available data is not rich enough to provide reliable information as to what extent these problems exist in the Zone. Hence...

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 reduces the number of transnational terror events in a country, while political decentralization has no impact. These results are robust to the choice of control variables and...

This article deals with intergovernmental relations in health within the 20 years of implantation of the Unified Health System (SUS), in the light of the historical course of Brazilian federalism and its implications to health. Initially, a theoretical-conceptual review was carried out on the topic of federalism, social welfare and federative coordination of health, considering the internationa...

Background. Decentralization of care and treatment for HIV infection in Africa makes services available in local health facilities. Decentralization has been associated with improved retention and comparable or superior treatment outcomes, but patient experiences are not well understood. Methods. We conducted a qualitative study of patient experiences in decentralized HIV care in Plateau State,...

The Philippines is one of several Asian countries that has decentralized the provision of health care to its local governments in recent decades. In the context of decentralization, a few studies have previously examined the issue of fiscal competition among local governments in the developing world. This report presents a summary of a published study that examined the existence of inter-jurisd...