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Optimising Decentralisation For The Health Sector By Exploring The Synergy Of Decision Space, Capacity And Accountability: Insights From The Philippines, Harvy Joy Liwanag, Kaspar Wyss

Ateneo School of Medicine and Public Health Publications

Background

Several studies on decentralisation have used the ‘decision space’ approach to assess the breadth of space made available to decision-makers at lower levels of the health system. However, in order to better understand how decentralisation becomes effective for the health sector, analysis should go beyond assessing decision space and include the dimensions of capacity and accountability. Building on Bossert’s earlier work on the synergy of these dimensions, we analysed decision-making in the Philippines where governmental health services have been devolved to local governments since 1992.

Methods

Using a qualitative research design, we interviewed 27 key decision-makers at different levels …