Does Fiscal Decentralization Improve Health Outcomes?

Does Fiscal Decentralization Improve Health Outcomes?
Author: David A. Robalino
Publisher: World Bank Publications
Total Pages: 20
Release: 2001
Genre: Descentralizacion
ISBN:

Decentralization of fiscal responsibilities has emerged as a primary objective on the agendas of national governments, and international organizations alike. Yet there is little empirical evidence on the potential benefits of this intervention. The authors fill in some quantitative evidence. Using panel data on infant mortality rates, GDP per capita, and the share of public expenditures managed by local governments, they find greater fiscal decentralization is consistently associated with lower mortality rates. The results suggest that the benefits of fiscal decentralization are particularly important for poor countries. They suggest also that the positive effects of fiscal decentralization on infant mortality, are greater in institutional environments that promote political rights. Fiscal decentralization also appears to be a mechanism for improving health outcomes in environments with a high level of ethno-linguistic fractionalization, however, the benefits from fiscal decentralization tend to be smaller.

Decentralization In Health Care: Strategies And Outcomes

Decentralization In Health Care: Strategies And Outcomes
Author: Saltman, Richard
Publisher: McGraw-Hill Education (UK)
Total Pages: 327
Release: 2006-12-01
Genre: Education
ISBN: 033521925X

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.

Crossing the Global Quality Chasm

Crossing the Global Quality Chasm
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 399
Release: 2019-01-27
Genre: Medical
ISBN: 0309477891

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.

Fiscal Decentralization and Local Finance in Developing Countries

Fiscal Decentralization and Local Finance in Developing Countries
Author: Roy Bahl
Publisher: Edward Elgar Publishing
Total Pages: 430
Release: 2018-03-30
Genre: Business & Economics
ISBN: 1786435306

This book draws on experiences in developing countries to bridge the gap between the conventional textbook treatment of fiscal decentralization and the actual practice of subnational government finance. The extensive literature about the theory and practice is surveyed and longstanding problems and new questions are addressed. It focuses on the key choices that must be made in decentralizing, on how economic and political factors shape the choices that countries make, and on how, by paying more attention to the need for a more comprehensive approach and the critical connections between different components of decentralization reform, everyone involved might get more for their money.

Fiscal Decentralization and the Efficiency of Public Service Delivery

Fiscal Decentralization and the Efficiency of Public Service Delivery
Author: Moussé Sow
Publisher: International Monetary Fund
Total Pages: 30
Release: 2015-03-17
Genre: Business & Economics
ISBN: 1475564031

This paper explores the impact of fiscal decentralization on the efficiency of public service delivery. It uses a stochastic frontier method to estimate time-varying efficiency coefficients and analyzes the impact of fiscal decentralization on those efficiency coefficients. The findings indicate that fiscal decentralization can improve the efficiency of public service delivery but only under specific conditions. First, the decentralization process requires adequate political and institutional environments. Second, a sufficient degree of expenditure decentralization seems necessary to obtain favorable outcomes. Third, decentralization of expenditure needs to be accompanied by sufficient decentralization of revenue. Absent those conditions, fiscal decentralization can worsen the efficiency of public service delivery.

Does Fiscal Decentralization Improve Health Outcomes? Evidence from a Cross-Country Analysis

Does Fiscal Decentralization Improve Health Outcomes? Evidence from a Cross-Country Analysis
Author: David A. Robalino
Publisher:
Total Pages: 14
Release: 2016
Genre:
ISBN:

Greater fiscal decentralization is consistently associated with lower mortality rates. And its positive effects on infant mortality are greater in institutional environments that promote political rights.Decentralization of fiscal responsibilities has emerged as a primary objective on the agendas of national governments and international organizations alike. Yet there is little empirical evidence on the potential benefits of this intervention. Robalino, Picazo, and Voetberg fill in some quantitative evidence.Using panel data on infant mortality rates, GDP per capita, and the share of public expenditures managed by local governments, they find that greater fiscal decentralization is consistently associated with lower mortality rates. The results suggest that the benefits of fiscal decentralization are particularly important for poor countries. They suggest also that the positive effects of fiscal decentralization on infant mortality are greater in institutional environments that promote political rights.Fiscal decentralization also appears to be a mechanism for improving health outcomes in environments with a high level of corruption. In environments with a high level of ethnolinguistic fractionalization, however, the benefits from fiscal decentralization tend to be smaller.This paper - a product of Human Development 1, Africa Technical Families - is part of a larger effort in the region to conduct rigorous analysis of the implications of fiscal decentralization on the financing and delivery of social services. The authors may be contacted at [email protected], [email protected]., or [email protected].

Primary Healthcare Spending

Primary Healthcare Spending
Author: Okore Apia Okorafor
Publisher: Juta and Company Ltd
Total Pages: 196
Release: 2010
Genre: Business & Economics
ISBN: 9781919895215

This book explores the implications of a wide range of intergovernmental fiscal arrangements found in fiscal federal systems and how they impact on the equitable distribution of primary health care resources. The issues raised in the book are relevant to all countries operating under a fiscal federal system and those that operate a decentralized health system.

Fiscal Decentralization Improves Social Outcomes When Countries Have Good Governance

Fiscal Decentralization Improves Social Outcomes When Countries Have Good Governance
Author: Ryota Nakatani
Publisher: International Monetary Fund
Total Pages: 29
Release: 2022-06-03
Genre: Business & Economics
ISBN:

Does fiscal decentralization improve health and educational outcomes? Does this improvement depend on the quality of governance? How do fiscal decentralization and governance interact? We answer these questions through an instrumental variable Tobit analysis of cross-country panel data. We find negative effects of fiscal decentralization on health outcomes, which however are more than offset by better governance. Education expenditure decentralization to subnational governments enhances educational outcomes. We conclude that countries can only reap the benefits from decentralization when the quality of their governance arrangements exceeds a certain threshold. We also find that sequencing and staging of decentralization matter. Countries should improve government effectiveness and control of corruption first to maximize benefits of fiscal decentralization.

Dangers of Decentralization

Dangers of Decentralization
Author: Remy Prud'homme
Publisher: World Bank Publications
Total Pages: 43
Release: 1994
Genre: Central-local government relations
ISBN:

Demand for decentralization is strong in most parts of the world. This close look at the negative side effects of improperly appled decentralization is not an attack on decentralization but an effort to prevent its misapplication -- and to promote fuller understanding and wiser use of this potentially desirable policy.