| Author: Hiroko Uchimure and Johannes Jütting |
| InfoShare Partner: OECD Development Centre |
| Publication Date: May 2006 |
| Type of Document: Article/Report/Paper |
| Topics: Financing/management, Policy/Law |
| Region: Asia/Pacific |
| Language: English |
| Additional information: Decentralisation can be important in substantially changing developing countries’ health sectors. There is no single recipe, but major indications of what works and what does not can be identified. The process and the policy context are crucial. The key is less choosing a big bang approach (the Philippines and Indonesia) over a gradual one (China and India) than ensuring that these changes are accompanied by reform of healthcare funding. Many countries are now rethinking their policy here and moving away from high OOP payments towards pre-payment through insurance or tax-funded healthcare provision. The real challenge, however, is to combine health sector financing reforms with the decentralisation process in such a way, that OOP payments are reduced and access to health care services improves.
Comments? Email: dev.contact@oecd.org |
| Number of Pages: 2 |
| File Size: 124 KB |
| File Format: Adobe Acrobat (PDF) To read PDF files, you must have Acrobat Reader installed. Visit Adobe's web site to get a free copy of Acrobat Reader. [download here]
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Decentralising health services – the transfer of power and responsibility from the central to the local level –
should help the poor if local resources, accountability and governance are in good shape. The process in China and India had negative effects because local governments remained under-funded and health was not seen as their priority. Contrary to this, decentralisation in Indonesia and the Philippines produced better health outcomes because they reformed healthcare funding. This is key to successful pro-poor decentralisation.
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