Decentralized Systems of Health Care Delivery and the Role of Large Cities : A Comparative Analysis
South Africa is going through an important political and administrative reorganization and a series of structural reforms. The responsibility for primary health care, which was mostly provincial, is about to be decentralized to the Local Government...
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| Format: | Working Paper |
| Language: | English en_US |
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World Bank, Washington, DC
2013
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| Online Access: | http://documents.worldbank.org/curated/en/2002/07/4101596/decentralized-systems-health-care-delivery-role-large-cities-comparative-analysis http://hdl.handle.net/10986/13622 |
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okr-10986-136222021-04-23T14:03:09Z Decentralized Systems of Health Care Delivery and the Role of Large Cities : A Comparative Analysis di Gropello, Emanuela ADMINISTRATIVE AUTONOMY ADMINISTRATIVE REGIONS ADMINISTRATIVE SYSTEMS CAPITATION CENTRAL GOVERNMENT CERTIFICATION CITIZENS CLINICS COLONIES CONSTITUTION COUNCILS DECENTRALIZATION DECENTRALIZATION PROCESS DECENTRALIZATION REFORM DECENTRALIZATION REFORMS DECISION MAKING DECONCENTRATION DEVOLUTION DISTRICTS EMPLOYMENT EXECUTION EXPENDITURES FEDERAL GOVERNMENT FINANCIAL RESOURCES FISCAL FISCAL CAPACITY FISCAL DECENTRALIZATION FISCAL REFORM FISCAL REVENUES GENERAL ELECTIONS GOVERNMENT LEVEL HEALTH CARE HEALTH CENTRES HEALTH FINANCING HEALTH PLANS HEALTH SECTOR HEALTH SYSTEMS HOSPITAL SERVICES HOSPITALS HUMAN DEVELOPMENT NETWORK HUMAN RESOURCES INSTITUTIONAL ARRANGEMENTS INSTITUTIONAL CAPACITY INTERMEDIARIES LACK OF AUTONOMY LARGE CITIES LAWS LEGISLATION LEVELS OF GOVERNMENT LOCAL ACCOUNTABILITY LOCAL AUTHORITIES LOCAL COUNCILS LOCAL GOVERNMENT LOCAL GOVERNMENTS MANAGERS MUNICIPAL GOVERNMENT MUNICIPAL GOVERNMENTS MUNICIPAL REVENUES MUNICIPALITIES MUNICIPALITY NATIONAL LEVEL NATIONAL POLICY NEEDS ASSESSMENT NUTRITION PATIENTS POLITICAL REFORMS PRIMARY HEALTH CARE PRIVATE SECTOR PRIVATIZATION PROPERTY TAXES PUBLIC HEALTH RESOURCE MOBILIZATION REVENUE SOURCES SOCIAL SECTORS SUPERVISION TECHNICAL ASSISTANCE USER CHARGES SOCIAL SERVICES HEALTH CARE DELIVERY HEALTH SYSTEMS DEVELOPMENT & REFORM ACCOUNTABILITY South Africa is going through an important political and administrative reorganization and a series of structural reforms. The responsibility for primary health care, which was mostly provincial, is about to be decentralized to the Local Government level. The main purpose of this paper is to analyze the on-going decentralization process in the Gauteng province and determine the role that Great Johannesburg can play within this new decentralized framework. To extract lessons and recommendations for Gauteng and Johannesburg, the paper takes a close look at the case of three middle -income Latin American countries, Chile, Colombia and Brazil, which offer valuable experience in the design and implementation of decentralized systems of health care delivery at the country and city level. It also looks at other international experiences. At the city level, the paper concludes that the case of Bogota in Colombia seems to be particularly relevant to the selection of a decentralized health care model for Johannesburg. It also shows that, in the longer run, the experiences provided by the current reforms in the UK and New Zealand would be worth looking at. Finally, a more general conclusion of the report is the finding that there is a wide range of possible roles for large cities in primary health care delivery and that the extent of this role will very much depend on the decentralization strategy adopted at the national level and on a number of key characteristics at the city level, among which the political and administrative structure, the fiscal and institutional capacity and the demographic structure could be identified. 2013-05-29T15:21:13Z 2013-05-29T15:21:13Z 2002-07 http://documents.worldbank.org/curated/en/2002/07/4101596/decentralized-systems-health-care-delivery-role-large-cities-comparative-analysis http://hdl.handle.net/10986/13622 English en_US HNP discussion paper series; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Working Paper Publications & Research Brazil Chile Colombia South Africa |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English en_US |
| topic |
ADMINISTRATIVE AUTONOMY ADMINISTRATIVE REGIONS ADMINISTRATIVE SYSTEMS CAPITATION CENTRAL GOVERNMENT CERTIFICATION CITIZENS CLINICS COLONIES CONSTITUTION COUNCILS DECENTRALIZATION DECENTRALIZATION PROCESS DECENTRALIZATION REFORM DECENTRALIZATION REFORMS DECISION MAKING DECONCENTRATION DEVOLUTION DISTRICTS EMPLOYMENT EXECUTION EXPENDITURES FEDERAL GOVERNMENT FINANCIAL RESOURCES FISCAL FISCAL CAPACITY FISCAL DECENTRALIZATION FISCAL REFORM FISCAL REVENUES GENERAL ELECTIONS GOVERNMENT LEVEL HEALTH CARE HEALTH CENTRES HEALTH FINANCING HEALTH PLANS HEALTH SECTOR HEALTH SYSTEMS HOSPITAL SERVICES HOSPITALS HUMAN DEVELOPMENT NETWORK HUMAN RESOURCES INSTITUTIONAL ARRANGEMENTS INSTITUTIONAL CAPACITY INTERMEDIARIES LACK OF AUTONOMY LARGE CITIES LAWS LEGISLATION LEVELS OF GOVERNMENT LOCAL ACCOUNTABILITY LOCAL AUTHORITIES LOCAL COUNCILS LOCAL GOVERNMENT LOCAL GOVERNMENTS MANAGERS MUNICIPAL GOVERNMENT MUNICIPAL GOVERNMENTS MUNICIPAL REVENUES MUNICIPALITIES MUNICIPALITY NATIONAL LEVEL NATIONAL POLICY NEEDS ASSESSMENT NUTRITION PATIENTS POLITICAL REFORMS PRIMARY HEALTH CARE PRIVATE SECTOR PRIVATIZATION PROPERTY TAXES PUBLIC HEALTH RESOURCE MOBILIZATION REVENUE SOURCES SOCIAL SECTORS SUPERVISION TECHNICAL ASSISTANCE USER CHARGES SOCIAL SERVICES HEALTH CARE DELIVERY HEALTH SYSTEMS DEVELOPMENT & REFORM ACCOUNTABILITY |
| spellingShingle |
ADMINISTRATIVE AUTONOMY ADMINISTRATIVE REGIONS ADMINISTRATIVE SYSTEMS CAPITATION CENTRAL GOVERNMENT CERTIFICATION CITIZENS CLINICS COLONIES CONSTITUTION COUNCILS DECENTRALIZATION DECENTRALIZATION PROCESS DECENTRALIZATION REFORM DECENTRALIZATION REFORMS DECISION MAKING DECONCENTRATION DEVOLUTION DISTRICTS EMPLOYMENT EXECUTION EXPENDITURES FEDERAL GOVERNMENT FINANCIAL RESOURCES FISCAL FISCAL CAPACITY FISCAL DECENTRALIZATION FISCAL REFORM FISCAL REVENUES GENERAL ELECTIONS GOVERNMENT LEVEL HEALTH CARE HEALTH CENTRES HEALTH FINANCING HEALTH PLANS HEALTH SECTOR HEALTH SYSTEMS HOSPITAL SERVICES HOSPITALS HUMAN DEVELOPMENT NETWORK HUMAN RESOURCES INSTITUTIONAL ARRANGEMENTS INSTITUTIONAL CAPACITY INTERMEDIARIES LACK OF AUTONOMY LARGE CITIES LAWS LEGISLATION LEVELS OF GOVERNMENT LOCAL ACCOUNTABILITY LOCAL AUTHORITIES LOCAL COUNCILS LOCAL GOVERNMENT LOCAL GOVERNMENTS MANAGERS MUNICIPAL GOVERNMENT MUNICIPAL GOVERNMENTS MUNICIPAL REVENUES MUNICIPALITIES MUNICIPALITY NATIONAL LEVEL NATIONAL POLICY NEEDS ASSESSMENT NUTRITION PATIENTS POLITICAL REFORMS PRIMARY HEALTH CARE PRIVATE SECTOR PRIVATIZATION PROPERTY TAXES PUBLIC HEALTH RESOURCE MOBILIZATION REVENUE SOURCES SOCIAL SECTORS SUPERVISION TECHNICAL ASSISTANCE USER CHARGES SOCIAL SERVICES HEALTH CARE DELIVERY HEALTH SYSTEMS DEVELOPMENT & REFORM ACCOUNTABILITY di Gropello, Emanuela Decentralized Systems of Health Care Delivery and the Role of Large Cities : A Comparative Analysis |
| geographic_facet |
Brazil Chile Colombia South Africa |
| relation |
HNP discussion paper series; |
| description |
South Africa is going through an
important political and administrative reorganization and a
series of structural reforms. The responsibility for primary
health care, which was mostly provincial, is about to be
decentralized to the Local Government level. The main
purpose of this paper is to analyze the on-going
decentralization process in the Gauteng province and
determine the role that Great Johannesburg can play within
this new decentralized framework. To extract lessons and
recommendations for Gauteng and Johannesburg, the paper
takes a close look at the case of three middle -income Latin
American countries, Chile, Colombia and Brazil, which offer
valuable experience in the design and implementation of
decentralized systems of health care delivery at the country
and city level. It also looks at other international
experiences. At the city level, the paper concludes that the
case of Bogota in Colombia seems to be particularly relevant
to the selection of a decentralized health care model for
Johannesburg. It also shows that, in the longer run, the
experiences provided by the current reforms in the UK and
New Zealand would be worth looking at. Finally, a more
general conclusion of the report is the finding that there
is a wide range of possible roles for large cities in
primary health care delivery and that the extent of this
role will very much depend on the decentralization strategy
adopted at the national level and on a number of key
characteristics at the city level, among which the political
and administrative structure, the fiscal and institutional
capacity and the demographic structure could be identified. |
| format |
Publications & Research :: Working Paper |
| author |
di Gropello, Emanuela |
| author_facet |
di Gropello, Emanuela |
| author_sort |
di Gropello, Emanuela |
| title |
Decentralized Systems of Health Care Delivery and the Role of Large Cities : A Comparative Analysis |
| title_short |
Decentralized Systems of Health Care Delivery and the Role of Large Cities : A Comparative Analysis |
| title_full |
Decentralized Systems of Health Care Delivery and the Role of Large Cities : A Comparative Analysis |
| title_fullStr |
Decentralized Systems of Health Care Delivery and the Role of Large Cities : A Comparative Analysis |
| title_full_unstemmed |
Decentralized Systems of Health Care Delivery and the Role of Large Cities : A Comparative Analysis |
| title_sort |
decentralized systems of health care delivery and the role of large cities : a comparative analysis |
| publisher |
World Bank, Washington, DC |
| publishDate |
2013 |
| url |
http://documents.worldbank.org/curated/en/2002/07/4101596/decentralized-systems-health-care-delivery-role-large-cities-comparative-analysis http://hdl.handle.net/10986/13622 |
| _version_ |
1764424265983066112 |