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 policyDifferentiate between political, fiscal, and administrative decentralization in health care systemsConsider public/private partnerships in health systemsExplain how the effects of decentralization can be evaluated.Present the newest data on the health outcomes of decentralizationExplore some challenges and global issues of health systems in the 21st centuryAnd 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"

The first textbook on public health intelligence presents in depth the key concepts, methods, and objectives of this increasingly important competency. It systematically reviews types of evidence and data that comprise intelligence, effective techniques for assessment, analysis, and interpretation, and the role of this knowledge in quality health service delivery. The book's learner-centered approach gives readers interactive context for mastering the processes of gathering and working with intelligence as well as its uses in informing public health decision-making. And its pragmatic framework will help establish standards for training, practice, and policy, leading to continued improvements in population health. This path-breaking resource: Offers a comprehensive, up-to-date introduction to public health intelligence, a core area of public health competency. Is suitable for both graduates' and healthcare professionals' training and development for national and international contexts. Helps readers apply theory to real-life scenarios, from multi-professional perspectives. Features activities, case studies, and discussion tasks for easy reader engagement. Anticipates and examines emerging developments in the field. Public Health Intelligence - Issues of Measure and Method is bedrock reading for postgraduate and advanced undergraduate students in public health, global health, health policy, health service management, nursing, medicine, statistics, epidemiology, quantitative methods, health intelligence, health inequality, and other allied healthcare fields. It is also a salient text for public health practitioners and health policymakers. "This book is a 'must-read' for students contemplating a career in Public Health or for anyone who is already in practice. The breadth of chapters from respected authors provide a detailed overview and critique of issues related to public health intelligence. A key strength of the book is that it is written with both students and practitioners in mind." Gurch Randhawa, PhD, FFPH, Professor of Diversity in Public Health & Director, Institute for Health Research, University of Bedfordshire, UK

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

The first textbook on public health intelligence presents in depth the key concepts, methods, and objectives of this increasingly important competency. It systematically reviews types of evidence and data that comprise intelligence, effective techniques for assessment, analysis, and interpretation, and the role of this knowledge in quality health service delivery. The book's learner-centered approach gives readers interactive context for mastering the processes of gathering and working with intelligence as well as its uses in informing public health decision-making. And its pragmatic framework will help establish standards for training, practice, and policy, leading to continued improvements in population health. This path-breaking resource: Offers a comprehensive, up-to-date introduction to public health intelligence, a core area of public health competency. Is suitable for both graduates' and healthcare professionals' training and development for national and international contexts. Helps readers apply theory to real-life scenarios, from multi-professional perspectives. Features activities, case studies, and discussion tasks for easy reader engagement. Anticipates and examines emerging developments in the field. Public Health Intelligence - Issues of Measure and Method is bedrock reading for postgraduate and advanced undergraduate students in public health, global health, health policy, health service management, nursing, medicine, statistics, epidemiology, quantitative methods, health intelligence, health inequality, and other allied healthcare fields. It is also a salient text for public health practitioners and health policymakers. "This book is a 'must-read' for students contemplating a career in Public Health or for anyone who is already in practice. The breadth of chapters from respected authors provide a detailed overview and critique of issues related to public health intelligence. A key strength of the book is that it is written with both students and practitioners in mind." Gurch Randhawa, PhD, FFPH, Professor of Diversity in Public Health & Director, Institute for Health Research, University of Bedfordshire, UK

Decentralization of health services is often contentious in both developed and developing nations. The aim of this text book was to conduct an in depth examination of the nature and impact of health system decentralization, using primary care service users' and providers' perspectives. Decentralization of health policy is a difficult area to investigate due to the lack of conceptual clarity about decentralization itself and the complexities of analysing policy processes, especially the attribution of outcomes to particular policies. The study shows that decentralization of health services is positively associated with increased access and utilisation of services and improved service delivery. This book contributes to the topical debate about decentralised services through the exploration of different approaches to assess the impact of decentralization, offering alternative framework for analysis. This book will also become one of the reading texts for anyone involved in teaching and research about decentralization and health services.