OBJECTIVE To identify trends and to describe the impact of health care decentralization on health financing policies in Mexico. METHODS The study population comprised four states selected according with six technical criteria: socioeconomic development, implementation of decentralization process, database on economical features, data consistency and reliability, and technical support from a m...

The Province of the Punjab underwent a number of attempts to decentralize the health sector in the 1990s. Among the most important were the decentralization of financial management within the district, the Sheikhupura PHC Pilot Project, the establishment of the District Health Authorities and District Health Management Teams, the creation of semi-autonomous hospitals and the programme of Distri...

Background In 2004, the health system in Iran initiated an organizational reform aiming to increase the autonomy of teaching hospitals and make them more decentralized. The policy led to the formation of a board of trustees in each hospital and significant modifications in hospitals’ financing. Since the reform aimed to improve its predecessor policy (implementation of hospital autonomy began i...

ence of three East Asian countries from the perspective of how well they have addressed the special features and requirements of the health sector. These features include the substantial role of externalities, the high degree of specialization, the critical role of quality and timeliness, and the high level of knowledge required to participate in the health care system at all levels. These char...

One of the limitations of cross-country health expenditure analysis refers to the fact that the financing, the internal organization and political restraints of health care decision-making are country-specific and heterogeneous. Yet, a way through is to examine the influence of such effects in those countries that have undertaken decentralization processes. In such a setting, it is possible to ...

In the last two decades, health sector decentralization policies have been implemented on a broad scale throughout the developing world, usually as part of a broader process of political, economic and technical reform (Litvack et al. 1998). This process has been fuelled by new efforts of democratization and processes for the ‘modernization’ of the state. These movements combined to promote acco...

BACKGROUND The Ghanaian health sector has undertaken several policies to help improve the quality of care received by patients. This includes the construction of several health facilities, the increase in the training of health workers, especially nurses, and the introduction of incentive packages (such as salary increase) to motivate health workers. The important question is to what extent doe...

The objective of the study was to analyze the status and explore the challenges to decentralization policy implementation in Nepal. Thirty seven key informants rich in experience and knowledge, seven focus group discussions, observation of six health facilities and analysis of about 25 key policy documents provided the data for this study. The study identified the challenges to the implementati...