TY - JOUR ID - 3229 TI - Low Decision Space Means No Decentralization in Fiji; Comment on “Decentralisation of Health Services in Fiji: A Decision Space Analysis” JO - International Journal of Health Policy and Management JA - IJHPM LA - en SN - AU - Faguet, Jean-Paul AD - Department of International Development & STICERD, London School of Economics, London, UK Y1 - 2016 PY - 2016 VL - 5 IS - 11 SP - 663 EP - 665 KW - Decentralization KW - Democracy KW - Local Government KW - Good Governance KW - Civil Society KW - Fiji DO - 10.15171/ijhpm.2016.82 N2 - Mohammed, North, and Ashton find that decentralization in Fiji shifted health-sector workloads from tertiary hospitals to peripheral health centres, but with little transfer of administrative authority from the centre. Decisionmaking in five functional areas analysed remains highly centralized. They surmise that the benefits of decentralization in terms of services and outcomes will be limited. This paper invokes Faguet’s (2012) model of local government responsiveness and accountability to explain why this is so – not only for Fiji, but in any country that decentralizes workloads but not the decision space of local governments. A competitive dynamic between economic and civic actors that interact to generate an open, competitive politics, which in turn produces accountable, responsive government can only occur where real power and resources have been devolved to local governments. Where local decision space is lacking, by contrast, decentralization is bound to fail because it has not really happened in the first place. UR - https://www.ijhpm.com/article_3229.html L1 - https://www.ijhpm.com/article_3229_2327af22894c19b20cb69636e79e79dc.pdf ER -