Download or read book Decentralizing Health Services written by Krishna Regmi and published by Springer Science & Business Media. This book was released on 2013-11-19 with total page 222 pages. Available in PDF, EPUB and Kindle. Book excerpt: Decentralizing Health Services A Global Perspective Krishna Regmi, editor Current economic, demographic, and environmental shifts are presenting major challenges to health care systems around the world. In response, decentralization--the transfer of control from central to local authorities--is emerging as a successful means of meeting these challenges and reducing inequities of care. But as with health care itself, one size does not fit all, and care systems must be responsive to global reality as well as local demand. Decentralizing Health Services explores a variety of applications of decentralization to health care delivery in both the developing and developed worlds. Outfitted with principles, blueprints, and examples, this ambitious text clearly sets out the potential role of decentralized care as a major player in public health. Its models of service delivery illustrate care that is effective, inclusive, flexible, and in tune with the current era of preventive and evidence-based healthcare . Contributors point out opportunities, caveats, and controversies as they: Clarify the relationships among decentralization, politics, and policy Differentiate between political, fiscal, and administrative decentralization in health care systems Consider public/private partnerships in health systems Explain how the effects of decentralization can be evaluated. Present the newest data on the health outcomes of decentralization Explore some challenges and global issues of health systems in the 21st century And each chapter features learning goals, discussion questions, activities, and recommendations for further reading Heralding changes poised to revolutionize care, Decentralizing Health Services will broaden the horizons of researchers and administrators in health services, health economics, and health policy
Download or read book Decentralization and Governance in the Ghana Health Sector written by Bernard F Couttolenc and published by World Bank Publications. This book was released on 2012-06-29 with total page 127 pages. Available in PDF, EPUB and Kindle. Book excerpt: In recent years, many countries, both developed and developing, have engaged in a process of decentralization of health service delivery and/or other functions of the health system. In most cases, decentralization has been adopted to improve accountability to local population, efficiency in service provision, equity in access and resource distribution, or to increase resource mobilization. Ghana has a long history of local government, going back to pre-independence times of the nineteenth century. By 1859 Municipal Councils were established in the major coastal towns of the then Gold Coast. Native Authorities, Councils and Courts were also established to administer law and order under the indirect authority of the colonial government; the limitations of this system was repeatedly put forward in the 1930s and 1940s, and reforms were introduced in 1951 by the Local Government Ordinance (Ahwoi 2010). The government has embarked in a decentralization policy since independence, which was strengthened and amplified by the local government act of 1993 and other legislations. At the present the Government of Ghana (GOG) is committed to strengthen the implementation of decentralization and for that purpose revise and strengthen the policy and regulatory framework governing decentralization. In spite of this long history and successive waves of decentralization reforms, effective decentralization in the country still faces considerable challenges, especially in large social sectors involving large structures. The public health sector is one that has not fully embraced the decentralization model adopted by the GOG, decentralization by devolution to the districts, for a number of reasons that will be discussed in this report. Some functions and responsibilities have been decentralized, but others remain centralized or simply deconcentrated.
Download or read book Fiscal Decentralization and Health Service Delivery written by Janet S. Cuenca and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: More than 25 years into the implementation of the Local Government Code of 1991, it is inconclusive whether fiscal decentralization indeed improves health service delivery in the Philippines. There is lack of studies that employ rigorous quantitative approach to address the research issue at hand. In this regard, the study attempts to contribute to the small body of literature and motivate further research and generation of reliable data that are crucial for evidence-based/informed policymaking. In particular, the study proposes an analytical framework that examines the effects of fiscal decentralization on health service delivery using difference-in-differences (DID) method. It draws up the standard measure of the extent/degree of fiscal decentralization affecting the health sector. Such endeavor is the first ever attempt to measure the extent/degree of health devolution in the Philippines, i.e., in terms of the health expenditure decentralization ratio. The output variables of interest include access to safe water and sanitation, health facility-based delivery, and access to hospital inpatient services. The control variables include two measures of fiscal decentralization to account for financial/fiscal autonomy of the local government units (LGUs) on the income side (i.e., the ratio of LGU own-source revenue to LGU expenditures and ratio of LGU own-source revenue to LGU income); LGU health spending as a proportion of total LGU expenditures; and per capita LGU income. The choice of variables was constrained by unavailability of disaggregated data at the LGU level. [...].
Download or read book Fiscal Decentralization and the Efficiency of Public Service Delivery written by Moussé Sow and published by International Monetary Fund. This book was released on 2015-03-17 with total page 30 pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper explores the impact of fiscal decentralization on the efficiency of public service delivery. It uses a stochastic frontier method to estimate time-varying efficiency coefficients and analyzes the impact of fiscal decentralization on those efficiency coefficients. The findings indicate that fiscal decentralization can improve the efficiency of public service delivery but only under specific conditions. First, the decentralization process requires adequate political and institutional environments. Second, a sufficient degree of expenditure decentralization seems necessary to obtain favorable outcomes. Third, decentralization of expenditure needs to be accompanied by sufficient decentralization of revenue. Absent those conditions, fiscal decentralization can worsen the efficiency of public service delivery.
Download or read book Decentralization In Health Care Strategies And Outcomes written by Saltman, Richard and published by McGraw-Hill Education (UK). This book was released on 2006-12-01 with total page 327 pages. Available in PDF, EPUB and Kindle. Book excerpt: Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.
Download or read book Does Fiscal Decentralization Improve Health Outcomes written by David A. Robalino and published by World Bank Publications. This book was released on 2001 with total page 20 pages. Available in PDF, EPUB and Kindle. Book excerpt: Decentralization of fiscal responsibilities has emerged as a primary objective on the agendas of national governments, and international organizations alike. Yet there is little empirical evidence on the potential benefits of this intervention. The authors fill in some quantitative evidence. Using panel data on infant mortality rates, GDP per capita, and the share of public expenditures managed by local governments, they find greater fiscal decentralization is consistently associated with lower mortality rates. The results suggest that the benefits of fiscal decentralization are particularly important for poor countries. They suggest also that the positive effects of fiscal decentralization on infant mortality, are greater in institutional environments that promote political rights. Fiscal decentralization also appears to be a mechanism for improving health outcomes in environments with a high level of ethno-linguistic fractionalization, however, the benefits from fiscal decentralization tend to be smaller.
Download or read book Decentralization and Service Delivery written by and published by World Bank Publications. This book was released on 2005 with total page 29 pages. Available in PDF, EPUB and Kindle. Book excerpt: Dissatisfied with centralized approaches to delivering local public services, a large number of countries are decentralizing responsibility for these services to lower-level, locally elected governments. The results have been mixed. The paper provides a framework for evaluating the benefits and costs, in terms of service delivery, of different approaches to decentralization, based on relationships of accountability between different actors in the delivery chain. Moving from a model of central provision to that of decentralization to local governments introduces a new relationship of accountability-between national and local policymakers-while altering existing relationships, such as that between citizens and elected politicians. Only by examining how these relationships change can we understand why decentralization can, and sometimes cannot, lead to better service delivery. In particular, the various instruments of decentralization-fiscal, administrative, regulatory, market, and financial-can affect the incentives facing service providers, even though they relate only to local policymakers. Likewise, and perhaps more significantly, the incentives facing local and national politicians can have a profound effect on the provision of local services. Finally, the process of implementing decentralization can be as important as the design of the system in influencing service delivery outcomes.
Download or read book Does Fiscal Decentralization Improve Health Outcomes Evidence from a Cross Country Analysis written by David A. Robalino and published by . This book was released on 2016 with total page 14 pages. Available in PDF, EPUB and Kindle. Book excerpt: Greater fiscal decentralization is consistently associated with lower mortality rates. And its positive effects on infant mortality are greater in institutional environments that promote political rights.Decentralization of fiscal responsibilities has emerged as a primary objective on the agendas of national governments and international organizations alike. Yet there is little empirical evidence on the potential benefits of this intervention. Robalino, Picazo, and Voetberg fill in some quantitative evidence.Using panel data on infant mortality rates, GDP per capita, and the share of public expenditures managed by local governments, they find that greater fiscal decentralization is consistently associated with lower mortality rates. The results suggest that the benefits of fiscal decentralization are particularly important for poor countries. They suggest also that the positive effects of fiscal decentralization on infant mortality are greater in institutional environments that promote political rights.Fiscal decentralization also appears to be a mechanism for improving health outcomes in environments with a high level of corruption. In environments with a high level of ethnolinguistic fractionalization, however, the benefits from fiscal decentralization tend to be smaller.This paper - a product of Human Development 1, Africa Technical Families - is part of a larger effort in the region to conduct rigorous analysis of the implications of fiscal decentralization on the financing and delivery of social services. The authors may be contacted at [email protected], [email protected]., or [email protected].
Download or read book Fiscal Decentralization and Local Finance in Developing Countries written by Roy Bahl and published by Edward Elgar Publishing. This book was released on 2018-03-30 with total page 430 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book draws on experiences in developing countries to bridge the gap between the conventional textbook treatment of fiscal decentralization and the actual practice of subnational government finance. The extensive literature about the theory and practice is surveyed and longstanding problems and new questions are addressed. It focuses on the key choices that must be made in decentralizing, on how economic and political factors shape the choices that countries make, and on how, by paying more attention to the need for a more comprehensive approach and the critical connections between different components of decentralization reform, everyone involved might get more for their money.
Download or read book On the Measurement and Impact of Fiscal Decentralization written by Robert D. Ebel and published by World Bank Publications. This book was released on 2002 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Is Decentralization Good for Development written by Jean-Paul Faguet and published by Oxford University Press, USA. This book was released on 2015 with total page 352 pages. Available in PDF, EPUB and Kindle. Book excerpt: Is decentralisation good for development? This book explains when the answer is 'Yes' and when it is 'No'. It shows how decentralisation can be designed to drive development forward, and focuses on the institutional incentives that can strengthen democracy, boost economies, and improve public sector performance.
Download or read book Primary Healthcare Spending written by Okore Apia Okorafor and published by Juta and Company Ltd. This book was released on 2010 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book explores the implications of a wide range of intergovernmental fiscal arrangements found in fiscal federal systems and how they impact on the equitable distribution of primary health care resources. The issues raised in the book are relevant to all countries operating under a fiscal federal system and those that operate a decentralized health system.
Download or read book Fiscal Federalism 2022 Making Decentralisation Work written by OECD and published by OECD Publishing. This book was released on 2021-12-20 with total page 290 pages. Available in PDF, EPUB and Kindle. Book excerpt: Fiscal Federalism 2022 surveys recent trends and policies in intergovernmental fiscal relations and subnational government. Accessible and easy-to-read chapters provide insight into: good practices in fiscal federalism; the design of fiscal equalisation systems; measuring subnational tax and spending autonomy; promoting public sector performance across levels of government; digitalisation challenges and opportunities; the role of subnational accounting and insolvency frameworks; funding and financing of local government public investment; and early lessons from the COVID-19 crisis for intergovernmental fiscal relations.
Download or read book EBOOK Decentralization in Health Care Strategies and Outcomes written by Richard Saltman and published by McGraw-Hill Education (UK). This book was released on 2006-12-16 with total page 327 pages. Available in PDF, EPUB and Kindle. Book excerpt: ·What are the characteristics that define a Social Health Insurance system? ·How is success measured in SHI systems? ·How are SHI systems developing in response to external pressures? Using the seven Social Health Insurance countries in western Europe - Austria, Belgium, France, Germany, Luxembourg, the Netherlands and Switzerland - as well as Israel, this important book reviews core structural and organizational dimensions, as well as recent reforms and innovations. Covering a wide range of policy issues, the book: ·Explores the pressures these health systems confront to be more efficient, more effective, and more responsive ·Reviews their success in addressing these pressures ·Examines the implications of change on the structure of SHI’s as they are currently defined ·Draws out policy lessons about past experience and likely future developments in SHI systems in a manner useful to policymakers in Europe and elsewhere Social Health Insurance Systems in Western Europe will be of interest to students of health policy and management as well as health managers and policy-makers. Contributors: Helmut Brand, Jan Bultman, Reinhard Busse, Laurent Chambaud, David Chinitz, Diana M.J. Delnoij, André P. den Exter, Aad A. de Roo, Anna Dixon, Isabelle Durand-Zaleski, Hans F.W. Dubois, Josep Figueras, Bernhard Gibis, Stefan Greß, Bernhard J. Güntert, Jean Hermesse, Maria M. Hofmarcher, Martin McKee, Pedro W. Koch-Wulkan, Claude Le Pen, Kieke G.H. Okma, Martin Pfaff, Richard B. Saltman, Wendy G.M. van der Kraan, Jürgen Wasem, Manfred Wildner, Matthias Wismar.
Download or read book Global Health Economics Shaping Health Policy In Low And Middle income Countries written by Paul Revill and published by World Scientific. This book was released on 2020-05-21 with total page 378 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book contains a collection of works showcasing the latest research into global health economics conducted by leading experts in the field from the Centre for Health Economics (CHE) at the University of York and other partner research institutions. Each chapter focuses upon an important topic in global health economics and a number of separate research projects. The discussion delves into health care policy evaluation; economic evaluation; econometric and other analytic methods; health equity and universal health coverage; consideration of cost-effectiveness thresholds and opportunity costs in the health sector; health system challenges and possible solutions; and others. Case study examples from a variety of low- and middle-income countries (LMIC) settings are also showcased in the final part of this volume.The research presented seeks to contribute toward increasing understanding on how health policy can be enhanced to improve the welfare of LMIC populations. It is strongly recommended for public health policymakers and analysts in low- and middle-income country settings and those affiliated to international health organizations and donor organizations.
Download or read book The Architecture of Government written by Daniel Treisman and published by Cambridge University Press. This book was released on 2007-07-02 with total page 295 pages. Available in PDF, EPUB and Kindle. Book excerpt: Since the days of Montesquieu and Jefferson, political decentralization has been seen as a force for better government and economic performance. It is thought to bring government 'closer to the people', nurture civic virtue, protect liberty, exploit local information, stimulate policy innovation, and alleviate ethnic tensions. Inspired by such arguments, and generously funded by the major development agencies, countries across the globe have been racing to devolve power to local governments. This book re-examines the arguments that underlie the modern faith in decentralization. Using logical analysis and formal modeling, and appealing to numerous examples, it shows that most are based on vague intuitions or partial views that do not withstand scrutiny. A review of empirical studies of decentralization finds these as inconclusive and mutually contradictory as the theories they set out to test.
Download or read book Transformation in Action written by Iraj Abedian and published by Juta and Company Ltd. This book was released on 1998 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt: The health services in South Africa have undergone a major reorientation in an attempt to provide the poorest and most vulnerable segments of society with increased access to affordable, quality health care. Unfortunately, the new policies and health plans have not translated into a commensurate improvement of actual health service delivery and health status. A key missing element has been the lack of an appropriate financial planning and budgeting system. This book, Transformation in Action, attempts to fill the void that exists between planning, budgeting and implementation in the public health sector. Drawing on local and international research and policy experiments, it outlines an alternative system called the Performance Budgeting System (PBS). Unlike the current budgeting system, the PBS system integrates financial planning and management with strategic, operational, performance and quality management objectives to ensure that, within budget constraints, service delivery outputs have the greatest possible impact on health outcomes. In so doing, this system can contribute substantially to achieving the objectives of recent public sector reform initiatives and the ideals of the Constitution.
