The Dangers of Fiscal Decentralisation in Healthcare: A Response to the Recent Commentaries

Document Type : Correspondence

Authors

1 Department of Sustainable Health, Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands

2 School of Social Sciences, Panteion University of Social and Political Sciences, Attika, Greece

3 Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

Keywords


Decentralisation has always been a key element of health systems strengthening; even back to 1978, the World Health Organization (WHO) Alma Ata Declaration clearly stated that the provision of fair, equal, and accessible healthcare should be decentralised and rooted in community-based approaches.1 However, decentralisation is not a uniform group of policies. On the contrary, it consists of a heterogeneous set of reforms aiming to the transfer of administrative, political and/or economic power from central governments to subnational authorities.2 In this sense decentralisation is not a synonym to fiscal decentralisation, nor the former necessarily entails the latter. ...(Read more...)

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Articles in Press, Corrected Proof
Available Online from 03 September 2023
  • Receive Date: 23 August 2023
  • Revise Date: 31 August 2023
  • Accept Date: 02 September 2023
  • First Publish Date: 03 September 2023