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Decentralization of health systems in Latin America

dc.contributor.authorBossert, Thomases_ES
dc.contributor.authorLarranaga, Osvaldoes_ES
dc.contributor.authorRuiz Meir, Fernandoes_ES
dc.date.accessioned2015
dc.date.available2015
dc.date.issued2000es_ES
dc.identifier.citationBossert, Thomas,Larranaga, Osvaldo,Ruiz Meir, Fernando (2000) Decentralization of health systems in Latin America. Rev Panam Salud Publica;8(1/2) -,jul.-ago. 2000. Retrieved from http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892000000700011&lng=pt&nrm=isoes_ES
dc.identifier.urihttp://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892000000700011&lng=pt&nrm=isoes_ES
dc.identifier.urihttps://iris.paho.org/handle/10665.2/8794
dc.format.extenttabes_ES
dc.relation.ispartofseriesRev Panam Salud Publica;8(1/2),jul.-ago. 2000es_ES
dc.subjectReforma dos Serviços de Saúdept_BR
dc.subjectDescentralizaçãopt_BR
dc.subjectBolíviaes_ES
dc.subjectChilees_ES
dc.titleDecentralization of health systems in Latin Americaes_ES
dc.typeJournal articlesen_US
dc.rights.holderPan American Health Organizationen_US
dc.description.notesDescentralization is often a major part of health reform policies. However, there have been few attempts to comparatively study the degree of decentralization and the effects of decentralization on equity of allocations to health, so we do not know how best to implement this reform. This article uses an innovative comparative analysis of the "decision space" that was allowed to local municipalities in the health reforms of Bolivia and Chile, two countries that have had several years of experience in implementing decentralization. The studies found that relatively little decision space was allowed to local authorities over key functions of health care systems. The studies also found that central authorities often reduce the decision space in order to direct more resources to health or to restrict local choice over human resources issues. The studies found that more equitable allocations of health funding were achieved through a common equalization fund for the municipalities in Chile and by forcing the assignment to health of a specific percentage of the central government transfers to municipalities in Boliviapt_BR


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