Decentralisation, Decision Space and Directions for Future Research; Comment on “Decentralisation of Health Services in Fiji: A Decision Space Analysis”

Document Type : Commentary


1 Kingston University, London, UK

2 Health Services Management Centre, University of Birmingham, Birmingham, UK


Decentralisation continues to re-appear in health system reform across the world. Evaluation of these reforms reveals how research on decentralisation continues to evolve. In this paper, we examine the theoretical foundations and empirical references which underpin current approaches to studying decentralisation in health systems.


Main Subjects

  1. Bossert T. Analyzing the decentralization of health systems in developing countries: decision space, innovation and performance. Soc Sci Med. 1998;47(10):1513-1527. doi:10.1016/s0277-9536(98)00234-2
  2. Mohammed J, North N, Ashton T. Decentralisation of health services in Fiji: a decision space analysis. Int J Health Policy Manag. 2015;5(3):173-181. doi:10.15171/ijhpm.2015.199
  3. Exworthy M,  Frosini F. Room for manoeuvre? Explaining local autonomy in the English National Health Service. Health Policy. 2008;86(2):204-212. doi:10.1016/j.healthpol.2007.10.008