OBJECTIVE To investigate the relation between decentralization and equity of resource allocation in Colombia and Chile. METHODS The "decision space" approach and analysis of expenditures and utilization rates were used to provide a comparative analysis of decentralization of the health systems of Colombia and Chile. FINDINGS Evidence from Colombia and Chile suggests that decentralization, u...

Mohammed, North, and Ashton find that decentralization in Fiji shifted health-sector workloads from tertiary hospitals to peripheral health centres, but with little transfer of administrative authority from the centre. Decisionmaking in five functional areas analysed remains highly centralized. They surmise that the benefits of decentralization in terms of services and outcomes will be limited....

The district health system in Ghana today is characterized by high resource-uncertainty and narrow decision-space. This article builds a theory-driven historical case study to describe the influence of path-dependent administrative, fiscal and political decentralization processes on development of the district health system and district manager decision-space. Methods included a non-exhaustive ...

Introduction Despite long-term commitment to decentralization in India, progress towards a decentralized form of governance has been rather slow. In Karnataka, despite state compliance with decentralised governance legislation from the mid-1980s, local bodies continue to suffer from inadequate power and resources. Under the National Rural Health Mission (NRHM), decentralization plays an importa...

Decentralization in the health sector has been widely implemented since the 1970s as a reform mechanism with mixed results. This study describes Fiji's 2 attempts at decentralizing its health sector and examines the implications they have had for the functions of planning, financing, and delivery of health services. The first wave attempted a major restructure by devolving Fiji's health system....

Objective The results of an evaluative longitudinal study, which identified the effects of health care decentralization on health financing in Mexico, Nicaragua and Peru are presented in this article. Methods The methodology had two main phases. In the first, secondary sources of data and documents were analyzed with the following variables: type of decentralization implemented, source of finan...

While decentralization of fiscal responsibilities is one of the main objectives that has emerged in the agenda of national governments and international organizations, there is little empirical evidence of the potential benefits of this intervention. This paper is an attempt to fill, in part, the void of quantitative measurement. Using panel data on infant mortality rates, GDP per capita, and t...

We examine the relationship between fiscal decentralization and the functional composition of public expenditures. Using a distance-sensitive representative agent model, we hypothesize that higher levels of fiscal decentralization induce agents to demand increased production of publicly provided private goods. We test this hypothesis using an unbalanced panel data set of 59 developed and develo...

Recent policy developments in public health care systems lead to a greater diversity in health care. Decentralization, either geographically or at an institutional level, is the key force, because it encourages innovation and local initiatives in health care provision. The devolution of responsibilities allows for a sort of 'deconstruction' of the status quo by changing both organizational form...