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This ambitious and insightful book provides a unique regional perspective on health policy across South Asia, focusing on how the decentralization of policy and governance leads to differing health outcomes across different countries in the region. Comparing the contexts and outcomes in Sri Lanka, Pakistan, India, Nepal, and Bangladesh, the book asks how power sharing arrangements between central and subnational layers of government nevertheless result in varying levels of success across issues such as infant and under-five mortality rates. The book argues that it is the role of central government in formulating policy, and how this feeds into regional implementation, that partly explains the disparities in health outcomes across the region. The book will interest students and scholars of South Asia politics, global health and health policy more generally.
This volume examines the myriad factors responsible for the poor state of the health sector in South Asia. It blends theoretical critiques of health sector reforms with micro and macro data to offer insights into issues of public health.
South Asia is a region of contrasts, with impressive technological achievements but also more than 40 percent of the world's poor. These contrasts are evident in the health sector, which demonstrates large variations in health, nutrition, and fertility outcomes.'Health Policy Research in South Asia' showcases some of the innovative qualitative and quantitative research methodologies being used in South Asia to provide empirical guidance for health sector reform and policy development. The four research areas presented are analysis of inequality, expenditure analysis, private sector analysis, and consumer and provider perspectives.Salient themes emerge from the 12 health policy research activities reviewed and emphasize the importance of strengthening local capacity and building ownership: • Governments can and should distribute subsidies in the health sector more efficiently and effectively. • The private sector, which dominates service delivery in most of South Asia, requires a different set of public sector policy instruments. • Informed consumers/citizens can and should play an important role in influencing health service delivery. • Empirical research can and should provide policymakers with some of the tools needed to improve and monitor the performance of the sector. This book will be of interest to health sector policymakers and analysts, to academics and students in public health and health economics, and to anyone with an interest in the impact ofhealth policy on development.
"This book describes the transition in Indian healthcare system since independence and contributes to the ongoing debate within development and institutional economics on the approaches towards reform in the public health system. The institutional reform perspective focuses on examining the effective utilisation of allotted resources and improvements in delivery through decentralisation in governance by ensuring higher participation of elected governments and local communities in politics, policymaking and delivery of health services. It discusses the economic (resource) reforms to explain the relevance and expansion of state interventionism along with its influence on the health sector, accountability and allocative efficiency. The author also explores the connections between neoliberal thought and privatisation in health sector, and examines the greater role of insurance-based financing and their implications for health service access and delivery. The book offers ways to address long-standing systemic and structural problems that confront the Indian healthcare system. Based on large-scale surveys and diverse empirical data on the Indian economy, this book will be of great interest to researchers, students and teachers of health economics, governance and institutional economics, political economy, sociology, public policy, regional studies and development studies. This will be useful to policymakers, health economists, social scientists, public health experts and professionals, and government and nongovernment institutions"--
This is a study of issues in good governance in South Asia, viz. in the countries of India, Pakistan, Sri Lanka and Nepal. The focus is on the interconnections between governance, decentralization (of authority and decision making) and poverty eradication. The book submits a stratagem to turn South Asia's greatest handicap, poverty, into a source of strength, in which the poor contribute directly to growth. The key to this pro-poor growth strategy, according to the authors, is community mobilization through social movements and non-governmental development initiatives. The book is divided into three parts, the conceptual framework, illustrative case studies and lessons for macro/microeconomic policy. Part I critically evaluates conventional developmental thinking and suggests the outline of an alternative pro-poor developmental strategy. Part II, the backbone of the volume, is a collection of six case studies from selected locations in south Asia, covering both rural and urban experiences. Part III draws lessons from these studies for a value-driven policy with both short-term and long-term implications. The book is a first of its kind, examining in-depth issues of vital importance to the development of the South Asian region. The importance of this volume lies in the synthesized lessons for policy and implementation drawn from cases where new ground has been broken in the conceptualization of social mobilization and pro-poor growth.
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.
The book assesses the policy actions of select Asian governments (China, India, Hong Kong, South Korea, Singapore and Thailand) to address critical health system functions from a policy design perspective. The findings show that all governments in the region have made tremendous strides in focussing their attention on the core issues and, especially, the interactions among them. However, there is still insufficient appreciation of the usefulness of public hospitals and their efficient management. Similarly, some governments have not made sufficient efforts to establish an effective regulatory framework which is especially vital in systems with a large share of private providers and payers. A well-run public hospital system and an effective framework for regulating private providers are essential tools to support the governance, financing, and payment reforms underway in the six health systems studied in this book.
This book explores the important topic of fiscal decentralization in Asian countries, and focuses on how government finance and administration are being reformed to bring budgetary decisions closer to voters. The focus on Asia is especially important because all countries in this region have been undergoing serious fiscal reforms in the past decade. They include one of the biggest decentralization reforms in Indonesia, significant reforms in democratic Philippines and Vietnam which are in transition, and Japan, whose fiscal reconstruction program is covered extensively. India and China, which are also covered, are very special cases because of their size and because their policies must fit decentralization into a significant economic growth scenario.