Decentralisation continues to re-appear in health system reform across the world. Evaluation of these reforms reveals how research on decentralisation continues to evolve. In this paper, we examine the theoretical foundations and empirical references which underpin current approaches to studying decentralisation in health systems.

Decentralisation has been described as an empty concept that lacks clarity. Yet there is an enduring interest in the process of decentralisation within health systems and public services more generally. Many claims about the benefits of decentralisation are not supported by evidence. It may be useful as an organising framework for analysis of health systems but in this context it lacks conceptu...

decentralisation continues to re-appear in health system reform across the world. evaluation of these reforms reveals how research on decentralisation continues to evolve. in this paper, we examine the theoretical foundations and empirical references which underpin current approaches to studying decentralisation in health systems.

2 The complexities of decentralisation 5 2.1 Types of decentralisation . . . . . . . . . . . . . . . . . . . . . . 5 2.2 Arguments for (and against) decentralisation . . . . . . . . . . . 6 2.2.1 Democracy . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2.2.2 E¢ciency . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 2.2.3 Development . . . . . . . . . . . . . . . . . . . . . . . . ...

Fiscal decentralisation can be defined as a two-dimensional policy institution that involves either decentralisation of a tax instrument, when local governments have the power to raise taxes, or decentralisation of expenditures when local governments bear the responsibility for implementing expenditure functions. The way in which fiscal decentralisation affects the "quality" of government activ...

This paper examines whether, given the increasing salience of subnational governments, political decentralisation has an impact on overall economic performance. It uses panel data analyses in order to determine the association between a number of the different indices of political decentralisation developed over the last decade and a half with two basic measures of economic performance: changes...

Decentralisation continues to re-appear in health system reform across the world. Evaluation of these reforms reveals how research on decentralisation continues to evolve. In this paper, we examine the theoretical foundations and empirical references which underpin current approaches to studying decentralisation in health systems.

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Significant changes in the global setting over the course of the last few decades resulted in an increasing prominence for the pursuit of transnational justice and individual accountability. The aftermath of the terrifying attacks on America on September 3. Making deep democratic decentralisation work • Moves towards democratic decentralisation in India • Elementary schools: Cake for the rich, ...

The health sector in Brazil has undergone important changes, particularly with the development of the Unified Health System (SUS). Decentralisation is an important principle of SUS and advances have been made in transferring responsibilities and resources to the local government units, known as municipios. This article describes the changes introduced, focusing on the system of municipio classi...