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 health policy

Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.

Looking at Canada, Brazil, Germany, Mexico, Nigeria, Pakistan, South Africa and Switzerland, Federalism and Decentralization in Health Care examines the overall organization of the health system.

Is decentralisation good for development? This book explains when the answer is 'Yes' and when it is 'No'. It shows how decentralisation can be designed to drive development forward, and focuses on the institutional incentives that can strengthen democracy, boost economies, and improve public sector performance.

A Brookings Institution Press and Ash Center for Democratic Governance and Innovation publication The trend toward greater decentralization of governance activities, now accepted as commonplace in the West, has become a worldwide movement. This international development—largely a product of globalization and democratization—is clearly one of the key factors reshaping economic, political, and social conditions throughout the world. Rather than the top-down, centralized decisionmaking that characterized communist economies and Third World dictatorships in the twentieth century, today's world demands flexibility, adaptability, and the autonomy to bring those qualities to bear. In this thought-provoking book, the first in a new series on Innovations in Governance, experts in government and public management trace the evolution and performance of decentralization concepts, from the transfer of authority within government to the sharing of power, authority, and responsibilities among broader governance institutions. This movement is not limited to national government—it also affects subnational governments, NGOs, private corporations, and even civil associations. The contributors assess the emerging concepts of decentralization (e.g., devolution, empowerment, capacity building, and democratic governance). They detail the factors driving the movement, including political changes such as the fall of the Iron Curtain and the ascendance of democracy; economic factors such as globalization and outsourcing; and technological advances (e.g. increased information technology and electronic commerce). Their analysis covers many different contexts and regions. For example, William Ascher of Claremont McKenna College chronicles how decentralization concepts are playing out in natural resources policy, while Kadmeil Wekwete (United Nations) outlines the specific challenges to decentralizing governance in sub-Saharan Africa. In each case, contributors explore the objectives of a decentralizing strategy as well as the benefits and difficulties that will likely result.

What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).

This report discusses several different approaches that support reforming health care services in developing countries. For some time now, health care services have been supported by government funds. As demands for improving health care services continue to increase additional demands will be placed on governments to respond. This, however, will not be easy. Slow economic growth and record budget deficits in the 1980's have forced reductions in public spending. Alternative approaches to finance health care services are needed. Such possible changes could involve: decentralization of federal government involvement; the promotion of nongovernment involvement; the imposition of user fees; and, establishing health insurance. Finally, the role of the Bank in pursuing new financing strategies is discussed.

In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.

Multi-criteria decision making (MCDM) has been extensively used in diverse disciplines, with a variety of MCDM techniques used to solve complex problems. A primary challenge faced by research scholars is to decode these techniques using detailed step-by-step analysis with case studies and data sets. The scope of such work would help decision makers to understand the process of using MCDM techniques appropriately to solve complex issues without making mistakes. Multi-Criteria Decision Analysis in Management provides innovative insights into the rationale behind using MCDM techniques to solve decision-making problems and provides comprehensive discussions on these techniques from their inception, development, and growth to their advancements and applications. The content within this publication examines hybrid multicriteria models, value theory, and data envelopment. Ideal for researchers, management professionals, students, operations scholars, and academicians, this scholarly work supports and enhances the decision-making process.