Decentralization of health systems in Ghana, Zambia, Uganda and the Philippines
A comparative analysis of decision space
Bibliographic Data
| ID | 15127246 |
|---|---|
| Authors | Thomas Bossert (0000-0002-3056-9543, Harvard University, corresponding author), T J Bossert |
| Year | 2002 |
| Volume | 17 |
| Issue | 1 |
| Pages | 14-31 |
| Publication date | 2002-03-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Health Policy and Planning (JOURNAL) |
| Journal identifiers | ISSN: 0268-1080 • E-ISSN: 1460-2237 |
| Publisher | Oxford University Press (PUBLISHER • GB) |
| DOI | 10.1093/heapol/17.1.14 |
| PMID | 11861583 |
| OpenAlex | W1983617101 |
| Language | EN |
| Citations received | 89 |
| References cited | 8 |
This study reviews the experience of decentralization in four developing countries: Ghana, Uganda, Zambia and the Philippines. It uses two analytical frameworks to describe and compare the types and degrees of decentralization in each country. The first framework specifies three types of decentralization: deconcentration, delegation and devolution. The second framework uses a principal agent approach and innovative maps of 'decision space' to define the range of choice for different functions that is transferred from the centre to the periphery of the system. The analysis finds a variety of different types and degrees of decentralization, with the Philippines demonstrating the widest range of choice over many functions that were devolved to local government units. The least choice was transferred through delegation to an autonomous health service in Ghana. Uganda and Zambia display variations between these extremes. There was insufficient evidence of the impact of decentralization to assess how these differences in 'decision space' influenced the performance of each health system. The authors suggest that this is a major area for future research.
Business · Decentralization · Delegation · Developing country · Devolution (biology) · Economic growth · Economics · Geography · Government (linguistics) · Management · Political science · Public economics · Regional science · Space (punctuation) · Variety (cybernetics) · Computer Science · Global Maternal and Child Health · Healthcare Systems and Reforms · Local Government Finance and Decentralization
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| Unique citing works | 89 |
|---|---|
| Citations per year | 3,87 |
| Citation span | 2003 - 2026 (24) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 86 |