Does Fiscal Decentralization Improve Health Outcomes

Author : David A. Robalino,Oscar F. Picazo,Albertus Voetberg
Publisher : World Bank Publications
Page : 20 pages
File Size : 47,7 Mb
Release : 2001
Category : Descentralizacion
ISBN : 8210379456XXX

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Does Fiscal Decentralization Improve Health Outcomes? by David A. Robalino,Oscar F. Picazo,Albertus Voetberg Pdf

Decentralization of fiscal responsibilities has emerged as a primary objective on the agendas of national governments, and international organizations alike. Yet there is little empirical evidence on the potential benefits of this intervention. The authors fill in some quantitative evidence. Using panel data on infant mortality rates, GDP per capita, and the share of public expenditures managed by local governments, they find greater fiscal decentralization is consistently associated with lower mortality rates. The results suggest that the benefits of fiscal decentralization are particularly important for poor countries. They suggest also that the positive effects of fiscal decentralization on infant mortality, are greater in institutional environments that promote political rights. Fiscal decentralization also appears to be a mechanism for improving health outcomes in environments with a high level of ethno-linguistic fractionalization, however, the benefits from fiscal decentralization tend to be smaller.

Author : David A. Robalino
Publisher : Unknown
Page : 14 pages
File Size : 40,7 Mb
Release : 2016
Category : Electronic
ISBN : OCLC:1290704861

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Does Fiscal Decentralization Improve Health Outcomes? Evidence from a Cross-Country Analysis by David A. Robalino Pdf

Greater fiscal decentralization is consistently associated with lower mortality rates. And its positive effects on infant mortality are greater in institutional environments that promote political rights.Decentralization of fiscal responsibilities has emerged as a primary objective on the agendas of national governments and international organizations alike. Yet there is little empirical evidence on the potential benefits of this intervention. Robalino, Picazo, and Voetberg fill in some quantitative evidence.Using panel data on infant mortality rates, GDP per capita, and the share of public expenditures managed by local governments, they find that greater fiscal decentralization is consistently associated with lower mortality rates. The results suggest that the benefits of fiscal decentralization are particularly important for poor countries. They suggest also that the positive effects of fiscal decentralization on infant mortality are greater in institutional environments that promote political rights.Fiscal decentralization also appears to be a mechanism for improving health outcomes in environments with a high level of corruption. In environments with a high level of ethnolinguistic fractionalization, however, the benefits from fiscal decentralization tend to be smaller.This paper - a product of Human Development 1, Africa Technical Families - is part of a larger effort in the region to conduct rigorous analysis of the implications of fiscal decentralization on the financing and delivery of social services. The authors may be contacted at [email protected], [email protected]., or [email protected].

Author : Ryota Nakatani,Qianqian Zhang,Isaura Garcia Valdes
Publisher : International Monetary Fund
Page : 29 pages
File Size : 48,5 Mb
Release : 2022-06-03
Category : Business & Economics
ISBN : 9798400211768

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Fiscal Decentralization Improves Social Outcomes When Countries Have Good Governance by Ryota Nakatani,Qianqian Zhang,Isaura Garcia Valdes Pdf

Does fiscal decentralization improve health and educational outcomes? Does this improvement depend on the quality of governance? How do fiscal decentralization and governance interact? We answer these questions through an instrumental variable Tobit analysis of cross-country panel data. We find negative effects of fiscal decentralization on health outcomes, which however are more than offset by better governance. Education expenditure decentralization to subnational governments enhances educational outcomes. We conclude that countries can only reap the benefits from decentralization when the quality of their governance arrangements exceeds a certain threshold. We also find that sequencing and staging of decentralization matter. Countries should improve government effectiveness and control of corruption first to maximize benefits of fiscal decentralization.

Author : Krishna Regmi
Publisher : Springer Science & Business Media
Page : 222 pages
File Size : 48,5 Mb
Release : 2013-11-19
Category : Medical
ISBN : 9781461490715

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Decentralizing Health Services by Krishna Regmi Pdf

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

Author : Saltman, Richard,Busse, Reinhard,Figueras, Josep
Publisher : McGraw-Hill Education (UK)
Page : 327 pages
File Size : 55,7 Mb
Release : 2006-12-01
Category : Education
ISBN : 9780335219254

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Decentralization In Health Care: Strategies And Outcomes by Saltman, Richard,Busse, Reinhard,Figueras, Josep Pdf

Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.

Author : Peter Friedrich
Publisher : Unknown
Page : 262 pages
File Size : 53,9 Mb
Release : 2004
Category : Electronic
ISBN : 3830507208

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Fiscal Decentralization by Peter Friedrich Pdf

Author : Okore Apia Okorafor
Publisher : Juta and Company Ltd
Page : 196 pages
File Size : 42,8 Mb
Release : 2010
Category : Social Science
ISBN : 1919895213

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Primary Healthcare Spending by Okore Apia Okorafor Pdf

This book explores the implications of a wide range of intergovernmental fiscal arrangements found in fiscal federal systems and how they impact on the equitable distribution of primary health care resources. The issues raised in the book are relevant to all countries operating under a fiscal federal system and those that operate a decentralized health system.

Author : Moussé Sow,Mr. Ivohasina Fizara Razafimahefa
Publisher : International Monetary Fund
Page : 30 pages
File Size : 44,8 Mb
Release : 2015-03-17
Category : Business & Economics
ISBN : 9781475564037

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Fiscal Decentralization and the Efficiency of Public Service Delivery by Moussé Sow,Mr. Ivohasina Fizara Razafimahefa Pdf

This paper explores the impact of fiscal decentralization on the efficiency of public service delivery. It uses a stochastic frontier method to estimate time-varying efficiency coefficients and analyzes the impact of fiscal decentralization on those efficiency coefficients. The findings indicate that fiscal decentralization can improve the efficiency of public service delivery but only under specific conditions. First, the decentralization process requires adequate political and institutional environments. Second, a sufficient degree of expenditure decentralization seems necessary to obtain favorable outcomes. Third, decentralization of expenditure needs to be accompanied by sufficient decentralization of revenue. Absent those conditions, fiscal decentralization can worsen the efficiency of public service delivery.

Author : Samer Al-Samarrai,The World Bank,Blane Lewis
Publisher : World Bank Publications
Page : 339 pages
File Size : 41,9 Mb
Release : 2021-07-23
Category : Business & Economics
ISBN : 9781464816932

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The Role of Intergovernmental Fiscal Transfers in Improving Education Outcomes by Samer Al-Samarrai,The World Bank,Blane Lewis Pdf

The majority of the world’s children live in countries where local governments are responsible for the provision of basic education services. Although subnational governments manage their own education systems, they often rely on transfers from the central government for funding. The main purpose of this study is to assess how these fiscal transfers affect public funding for education and how they ultimately affect student schooling and learning outcomes. Through a careful analysis of how fiscal transfers have affected education systems in different contexts, the investigation develops a set of principles to support improvements in the design and implementation of transfer systems with a specific focus on the provision of education services. The study is centered on seven country case studies that aim to answer a set of common research questions using a similar approach. Country case studies were conducted in Brazil, Bulgaria, China, Colombia, Indonesia, Sudan, and Uganda. The analysis shows that fiscal transfer mechanisms can improve the adequacy of public education spending, reduce spending inequalities between regions, and improve spending efficiency. Moreover, the study highlights that carefully designed and implemented transfer systems can help raise overall education outcomes and reduce education inequality. This publication was funded by a grant from the Results in Education for All Children (REACH) trust fund at the World Bank. REACH is supported by the government of Germany through theFederal Ministry for Economic Cooperation and Development, the government of Norway through NORAD, and the government of the United States of America through the U.S. Agency for International Development.

Author : Roy Bahl,Richard M. Bird
Publisher : Edward Elgar Publishing
Page : 512 pages
File Size : 43,9 Mb
Release : 2018-03-30
Category : Business & Economics
ISBN : 9781786435309

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Fiscal Decentralization and Local Finance in Developing Countries by Roy Bahl,Richard M. Bird Pdf

This book draws on experiences in developing countries to bridge the gap between the conventional textbook treatment of fiscal decentralization and the actual practice of subnational government finance. The extensive literature about the theory and practice is surveyed and longstanding problems and new questions are addressed. It focuses on the key choices that must be made in decentralizing, on how economic and political factors shape the choices that countries make, and on how, by paying more attention to the need for a more comprehensive approach and the critical connections between different components of decentralization reform, everyone involved might get more for their money.

Author : Jennie Ilene Litvack,Junaid Ahmad,Richard Miller Bird
Publisher : World Bank Publications
Page : 52 pages
File Size : 48,8 Mb
Release : 1998-01-01
Category : Business & Economics
ISBN : 0821343505

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Rethinking Decentralization in Developing Countries by Jennie Ilene Litvack,Junaid Ahmad,Richard Miller Bird Pdf

In an effort to reduce poverty and improve nutrition, this Bank operation assisted the Indian program Operation Flood to develop the dairy industry in India. This study examines the policy changes instituted to support the aid flow to the dairy sector and discusses the lessons learned and benefits realized through improved dairy production. It also presents suggestions for improvement. This program differs from other Bank efforts in that it focuses on a single commodity to alleviate poverty and raise living standards.

Author : Ehtisham Ahmad,Giorgio Brosio
Publisher : Edward Elgar Publishing
Page : 411 pages
File Size : 41,7 Mb
Release : 2009-01-01
Category : Political Science
ISBN : 9781849801850

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Does Decentralization Enhance Service Delivery and Poverty Reduction? by Ehtisham Ahmad,Giorgio Brosio Pdf

Does decentralization enhance service delivery and poverty reduction? The expert contributors to this book address this fundamental question faced by policymakers and scholars in developing and advanced countries. The book illustrates that it is equally important for international agencies as well as bilateral donors to provide advice and assistance on decentralization that effectively supports poverty reduction. The volume builds on insights from the recent, political economy developments in the intergovernmental literature reviewed in the Handbook of Fiscal Federalism, and presents new empirical evidence on the effects of decentralization in different parts of the world. Policy-oriented papers evaluating the effectiveness of decentralized service delivery are presented. The role of institutions and the importance of sequencing of policies in ensuring effective outcomes are also considered. The volume presents some insightful empirical studies of the decentralization process from Latin America, Eastern Europe, and Africa. With a detailed empirical analysis of effective outcomes of public policies implemented at the sub-national level, and a focus on method, this book will be of great interest to academics specializing in public sector economics and public finance, and to national and international policymakers.

Author : Robert D. Ebel,Serdar Yilmaz
Publisher : World Bank Publications
Page : 32 pages
File Size : 50,5 Mb
Release : 2002
Category : Central-local government relations
ISBN : 8210379456XXX

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On the Measurement and Impact of Fiscal Decentralization by Robert D. Ebel,Serdar Yilmaz Pdf

Author : Bernard F Couttolenc
Publisher : World Bank Publications
Page : 126 pages
File Size : 43,6 Mb
Release : 2012-07-06
Category : Business & Economics
ISBN : 9780821395905

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Decentralization and Governance in the Ghana Health Sector by Bernard F Couttolenc Pdf

Ghana's government has embarked on a decentralization process since the 1980s, but the intended devolution of the health system faces important challenges and shortfalls. This study analyzes the strengths and weaknesses of the decentralization of the Ghanaian health system.

Author : Jean-Paul Faguet,Caroline Pöschl
Publisher : Oxford University Press, USA
Page : 352 pages
File Size : 45,6 Mb
Release : 2015
Category : Business & Economics
ISBN : 9780198737506

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Is Decentralization Good for Development? by Jean-Paul Faguet,Caroline Pöschl Pdf

"This book is a product of the Initiative for Policy Dialogue's Decentralization Task Force, and was first conceived at a conference held at Columbia University in New York in 2009"--Page vii.