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 healthpolicy