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Decentralisation, Governance and Health-System Performance: 'Where You Stand Depends on Where You Sit'

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  • Andrew Mitchell
  • Thomas J. Bossert

Abstract

Advocates of local government often argue that when decentralisation is accompanied by adequate mechanisms of accountability, particularly those responsive to local preferences, improved service delivery will result. From the perspective of the health sector, the appropriate degree of decentralisation and the necessary mechanisms of accountability depend upon the achievement of health system goals. Drawing on evidence from six countries (Bolivia, Chile, India, Pakistan, Philippines, Uganda), this article comes to the conclusion that a balance between centralisation of some functions and decentralisation of others, along with improved mechanisms of accountability, is needed to achieve health system objectives. Copyright (c) The Authors 2010. Development Policy Review (c) 2010 Overseas Development Institute..

Suggested Citation

  • Andrew Mitchell & Thomas J. Bossert, 2010. "Decentralisation, Governance and Health-System Performance: 'Where You Stand Depends on Where You Sit'," Development Policy Review, Overseas Development Institute, vol. 28(6), pages 669-691, November.
    • Handle: RePEc:bla:devpol:v:28:y:2010:i:6:p:669-691
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    Citations

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    Cited by:

    1. Zarychta, Alan, 2020. "Making social services work better for the poor: Evidence from a natural experiment with health sector decentralization in Honduras," World Development, Elsevier, vol. 133(C).
    2. André Martínez Fritscher & Carolina Rodríguez Zamora, 2016. "An Evaluation of the 1997 Expenditure Decentralization Reform in Mexico," Public Finance Review, , vol. 44(5), pages 563-588, September.
    3. Makokha, Racheal Omukhulu, 2017. "Does Decentralization Improve Provision of Health Services? Evidence from Kisumu and Makueni Counties in Kenya," Thesis Commons xef7a, Center for Open Science.
    4. Duncan M. Wagana & Mike A. Iravo & Joyce D. Nzulwa & John M. Kihoro, 2016. "Effect of Financial and Political Decentralization on Service Delivery in County Governments in Kenya," International Journal of Academic Research in Business and Social Sciences, Human Resource Management Academic Research Society, International Journal of Academic Research in Business and Social Sciences, vol. 6(6), pages 304-320, June.
    5. Feldhaus, Isabelle & Chatterjee, Susmita & Clarke-Deelder, Emma & Brenzel, Logan & Resch, Stephen & Bossert, Thomas J., 2023. "Examining decentralization and managerial decision making for child immunization program performance in India," Social Science & Medicine, Elsevier, vol. 317(C).
    6. Niccol? Persiani & Martina Giusti & Maria Jose Caldes & Afef Hagi, 2022. "Il contributo del management alla definizione della strategia di decentramento del Servizio Sanitario: il caso del Servizio Sanitario Tunisino," MECOSAN, FrancoAngeli Editore, vol. 2022(122), pages 85-103.
    7. Geiguen Shin & Byong‐Kuen Jhee, 2021. "Better service delivery, more satisfied citizens? The mediating effects of local government management capacity in South Korea," Asia and the Pacific Policy Studies, Wiley Blackwell, vol. 8(1), pages 42-67, January.
    8. Solveig Danielsen & Frank B. Matsiko, 2016. "Using a plant health system framework to assess plant clinic performance in Uganda," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 8(2), pages 345-359, April.

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