Health sector reform is defined as sustained, purposeful change to improve the efficiency, equity and effectiveness of the health sector. Any change is not reform. Changes that affect at least two of the elements namely; health financing, expenditure, organization regulation and consumer behavior justify to be called as health sector reforms. Suggested reforms before introduction must undergo a...

Given the problematic nature of attempts to reform national delivery systems for health care, the paper reviews the context and logic of reforms in the health sector. After a background on approaches to building capacity within three generations of public sector reforms, it examines the reforms applied to financing, organizing and delivering health services and suggests strategies for reform th...

Given the problematic nature of attempts to reform national delivery systems for health care, the paper reviews the context and logic of reforms in the health sector. After a background on approaches to building capacity within three generations of public sector reforms, it examines the reforms applied to financing, organizing and delivering health services and suggests strategies for reform th...

It is widely accepted that the deficiencies in public sector health system can only be overcome by significant reforms. The need for reforms in India s health sector has been emphasized by successive plan documents since the Eighth Five-Year Plan in 1992, by the 2002 national health policy and by international donor agencies. The World Bank (2001:12,14), which has been catalytic in initiating h...

Background The rising burden of disease and weak health systems are being compounded by the persistent economic downturn, re-emerging diseases, and violent conflicts. There is a growing recognition that the global health agenda needs to shift from an emphasis on disease-specific approaches to strengthening of health systems, including dealing with social, environmental, and economic determinant...

Public sector reforms for several decades have been premised on the assumption that improving the ability of government to manage its business will lead to improved social and economic progress. The 1997 World Bank Report describes a first generation of reforms in which steps were taken to cut government expenditures and to revive the private sector. Measures included budget cuts, tax reforms, ...

Motivation in the work context can be defined as an individual's degree of willingness to exert and maintain an effort towards organizational goals. Health sector performance is critically dependent on worker motivation, with service quality, efficiency, and equity, all directly mediated by workers' willingness to apply themselves to their tasks. Resource availability and worker competence are ...

Equity was a core value in the Alma Ata declaration on PHC. However, the interpretation of equity varied and its application became difficult. Equity goals and objectives have often been rhetoric rather than practical. Policy reforms since Alma Ata have been dominated by the neo-liberal economic ideology, which does not include equity as its core value. After 25 years, reforms such as the essen...