Health Systems and Decentralization

Chapter

Abstract

Health systems are comprised of many programmes, functions and interventions tailored to improve people’s health. All health systems share certain common features, such as the ways they are organised and financed and deliver services. Providing better health systems means maintaining people’s good health, fairness of financial contribution and delivering responsive health-care services to those who need them. This chapter provides a global overview of health systems with an emphasis on decentralised systems in low- and middle-income countries. Examples from different country systems and circumstances are discussed to provide a real context and draw attention to variations in system configuration.

Keywords

Economic Crisis Europe Income Congo Sudan 

References

  1. Akin, J., Hutchinson, P., & Strumpf, K. (2005). Decentralization and government provision of public goods: The public health sector in Uganda. The Journal of Development Studies, 41(8), 1417–1443.CrossRefGoogle Scholar
  2. Atun, R. (2012). Health systems, systems thinking and innovation. Health Policy and Planning, 27, iv4–iv8.PubMedCrossRefGoogle Scholar
  3. Bankauskaite, V., & Saltman, R. (2007). Central issues in the decentralization debate. In R. Saltman, V. Bankauskaite, & K. Vrangbaek (Eds.), Decentralization in healthcare (pp. 11–27). Maidenhead: Open University Press.Google Scholar
  4. Berman, P. & Bossert, T. (2000) A decade of health sector reform in developing countries: what have we learned? A Paper prepared for the DDM Symposium – Appraising a decade of health sector reform in developing countries. Washington DC, March 2000Google Scholar
  5. Bossert, T. (1998). Analysing the decentralization of health systems in developing countries: Decision space, innovation, and performance. Social Science and Medicine, 47, 1513–1527.PubMedCrossRefGoogle Scholar
  6. Busse, R., & Wismar, M. (2002). Health target programmes and health care services—any link? A conceptual and comparative study. Health Policy, 59, 209–221.PubMedCrossRefGoogle Scholar
  7. Cassels, A. (1995). Health sector reform: Key issues in less developed countries. Journal of International Development, 7, 329–347.PubMedCrossRefGoogle Scholar
  8. Centre for Global Development. (2006). When will we ever learn? Improving lives through impact evaluation. Report of the evaluation working group. Washington, DC: Centre for Global Development.Google Scholar
  9. Dekker, E. (1994). Healthcare reform and public health. European Journal of Public Health, 4, 281–286.CrossRefGoogle Scholar
  10. Figueras, J., & McKee, M. (2012). Health systems, health, wealth and societal well-being. Maidenhead: Open University Press.Google Scholar
  11. Gilson, L. (1997). Implementing and evaluating health reform processes: lessons from the literature. Bethesda, Maryland: Partnerships for Health Reform.Google Scholar
  12. Hafner, T., & Shiffman, J. (2013). The emergence of global attention to health systems strengthening. Health Policy and Planning, 28(1), 41–50.PubMedCrossRefGoogle Scholar
  13. Hunter, D. J., Veinonen, M., & Wlodarczyk, W. C. (1998). Optimal balance of centralised and decentralised management. In R. Saltman, J. Figueras, & C. Sakellarides (Eds.), Critical challenges in healthcare reform in Europe. Buckingham: Open University Press.Google Scholar
  14. Knowles, J., Leighton, C., & Stinson, W. (1997). Measuring health sector reform for system performance: a handbook of indicators. Bethesda, MD: Partners for Health Reformplus, Abt Associates Inc.Google Scholar
  15. Lauer, J., Lovell, C., Murray, C., & Evans, D. (2004). World health systems performance revisited: the impact of varying the relative importance of health system goals. BMC Health Services Research, 4, 19.PubMedCrossRefGoogle Scholar
  16. Leighton, C. (1996). Strategies for achieving health financing reform in Africa. World Development, 2(4), 431–451.Google Scholar
  17. Mills, A., & Ranson, M. (2012). The design of health systems. In M. Merson, R. Black, & A. Mills (Eds.), Global health: diseases, programs, systems and policies (pp. 618–619). Burlington, MA: Jones & Bartlett.Google Scholar
  18. Mladovsky, P., Srivastava, D., Cylus, J., Karanikolos, M., Evetovits, T., Thomson, S., & McKee, M. (2012). Health policy in the financial crisis. EuroHealth: Quarterly of the European Observatory on Health Systems and Policies, 18(1), 3–6.Google Scholar
  19. Newell, J. N., Collins, C., Baral, S., Omar, M., & Pande, S. (2005). Decentralization and TB control in Nepal: Understanding the views of TB control staff. Health Policy, 73(2), 212–227.PubMedCrossRefGoogle Scholar
  20. Oats, W. E. (1999). An essay on fiscal decentralization. Journal of Economic Literature, 37(3), 1120–1149.CrossRefGoogle Scholar
  21. Owin, W., Korir, J., Ocholla, P., & Oloo, K. (2000). Decentralization and health systems development: The question of planning, budgeting and financial structures. Nairobi, Kenya: Institute of Policy Analysis and Research.Google Scholar
  22. Partners for Health Reformplus. (2006). Insights for implementation: Improving health systems performance through monitoring and evaluation. Bethesda, MD: Partners for Health Reformplus, Abt Associates Inc.Google Scholar
  23. Peckham, S., Exworthy, M., Powell, M., & Greener, I. (2005). Decentralization as an organisational model for healthcare in England. London: NCCSDO.Google Scholar
  24. Piette, J. D., Lun, K. C., Moura, L. A., Jr., Fraser, H. S., Mechael, P. N., et al. (2012). Impacts of e-health on the outcomes of care in low- and middle-income countries: Where do we go from here? Bulletin of the World Health Organisation, 90, 365–372.CrossRefGoogle Scholar
  25. Roberts, M., Hsiao, W., Berman, P., & Reich, M. (2004). Getting health reform right. Oxford: Oxford University Press.Google Scholar
  26. Roemer, M. I. (1991). National health systems of the world: Vol 1. The countries. Oxford: Oxford University Press.Google Scholar
  27. Saltman, R. B. (1994). A conceptual overview of recent healthcare reforms. European Journal of Public Health, 4, 287–293.CrossRefGoogle Scholar
  28. Saltman, R., Bankauskaite, V., & Vrangbaek, K. (2007). Decentralization in healthcare. Maidenhead: Open University Press.Google Scholar
  29. Sikosana, P., Dlamini, Q., & Issakov, A. (1997). Health sector reform in sub-Saharan Africa: A review of experiences, information gaps and research needs. Geneva, Switzerland: WHO.Google Scholar
  30. Simon, H. A. (1982). Models of bounded rationality. Cambridge, MA: The MIT Press.Google Scholar
  31. Smith, R.D. & Hanson, K. (2011). Health systems in low- and middle-income countries: An economic and policy perspective. Oxford Scholarship OnlineGoogle Scholar
  32. Thomas, S., Keegan, C., Barry, S., & Layte, R. (2012). The Irish health system and the economic crisis. The Lancet, 380(9847), 1056–1057.CrossRefGoogle Scholar
  33. Travis, P., Bennett, S., Haines, A., Pang, T., Bhutta, Z., et al. (2004). Overcoming health systems constraints to achieve the Millennium Development Goals. Lancet, 364(9437), 900–906.PubMedCrossRefGoogle Scholar
  34. Wang, Y., Collins, C., Tang, S., & Martineau, T. (2002). Health systems decentralization and human resources management in low and middle income countries. Public Administration and Development, 22, 439–453.CrossRefGoogle Scholar
  35. Weber, M. (1947). The theory of social and economic organisation. New York: Oxford University Press.Google Scholar
  36. World Bank. (1993). World development report: Investing in health. New York: Oxford University.Google Scholar
  37. World Health Organization. (2000). The World Health Report 2000: Health systems: Improving performance. Geneva, Switzerland: World Health Organization.Google Scholar
  38. World Health Organization. (2005). Building stronger health systems key to reaching the health Millennium Development Goals. Geneva, Switzerland: World Health Organization.Google Scholar
  39. World Health Organization. (2006). Opportunities for global health initiatives in the health system action agenda. Working paper no. 4. Geneva, Switzerland: World Health Organization.Google Scholar
  40. World Health Organization. (2007). Everybody’s business: Strengthening health systems to improve health outcomes: WHO’s framework for action. Geneva, Switzerland: World Health Organization.Google Scholar
  41. World Health Organization. (2010a). The World Health Report: Health systems financing: The path to universal coverage. Geneva, Switzerland: World Health Organization.Google Scholar
  42. World Health Organization. (2010b). Key components of a well functioning health system. Geneva, Switzerland: World Health Organization.Google Scholar
  43. Zakus, D., & Bhattacharyya, O. (2007). Health systems, management, and organization in low- and middle-income countries. In W. Markle, M. Fisher, & R. Smego Jr. (Eds.), Understanding global health. New York: The McGraw-Hill Companies. http://www.oucom.ohiou.edu/international/updates/UnderstdGlobalHealth_FW_TOC.pdf and http://www.hsph.harvard.edu/takemi/files/2012/10/RP248.pdf (Accessed 17/5/2013).Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Institute for Health and Human DevelopmentUniversity of East LondonLondonUK
  2. 2.Department of Clinical Education and Leadership, Faculty of Health & Social Sciences - Institute for Health ResearchUniversity of BedfordshireLutonUK

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