Governance and health
- Fiscal decentralisation, Chinese style: good for health outcomes?
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This Institute of Developing Economies discussion paper analyses the effect of fiscal decentralisation on health outcomes in China. Fiscal decentralisation refers to the transfer of authority and resources from central to local tiers of government for the provision of local health services. The paper finds that counties in more fiscally decentralised provinces have lower infant mortality rates.
Health systems are strongly influenced by the institutional framework within which they operate. This section of the resource guide explores some of the relationships that influence provision of health services.
The government plays a central role in establishing the institutional framework for the health sector. It provides broad policy directions. It defines the terms and conditions of public sector employment and the relationship between central and local governments and providers of health services. It also legislates and enforces regulations to prevent dangerous practices and protect the public.
A wide variety of organisations have a stake in the health sector, including bodies that represent different categories of health workers, groups of users of services and non-governmental providers of services. Their behaviour strongly influences the implementation of health policies and they need to be involved in decisions that affect their members.
Users of health services also influence providers. One way to make them more effective is to provide information on the kinds of services they require and on the performance of health facilities. Another way is to provide mechanisms through which they can voice their concerns and participate in monitoring provider performance.
For more information on wider governance issues, see the Governance and Social Development Resource Centre.
Latest Additions
- Impact of medical tourism on health services for local populations
- ( S. M. Wolfe / Public Citizen , 2006)
- This article published by the Public Citizen Health Research Group, is the first in a two part series that focuses on medical tourism – travelling with the express purpose of obtaining health se...
- Impact of medical tourism on access to health care in rural areas
- ( N. M. Vijay / Third World Network , 2007)
- This article, produced by the Third World Network, looks at the impact of medical tourism in India. In this instance, medical tourism refers to the practice where people from rich nations travel to po...
