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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.
Why do some societies fare well, and others poorly, at reducing the risk of early death? Wealth, Health, and Democracy in East Asia and Latin America finds that the public provision of basic health care and other inexpensive social services has reduced mortality rapidly even in tough economic circumstances, and that political democracy has contributed to the provision and utilization of such social services, in a wider range of ways than is sometimes recognized. These conclusions are based on case studies of Argentina, Brazil, Chile, Costa Rica, Indonesia, South Korea, Taiwan, and Thailand, as well as on cross-national comparisons involving these cases and others.
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.
This report states that the future of East Asian countries depends on the capacity and performance of local and provincial governments. Decentralization has unleashed local initiative and energy, with new ways to deliver services to people, with potential for continued improvement. The report, which focuses on six countries, notes the differences in the approach to decentralizing government in Cambodia, China, Indonesia, the Philippines, Thailand, and Vietnam
East Asian and Pacific countries are growing rapidly. They need high quality, well-funded health systems to underpin their population growth and assure continued productivity and economic growth. But countries will need to spend wisely, using modern techniques of insurance and strategic contracting with providers.
Comparative and interdisciplinary perspectives on the current trend in the developing world of devolving political and economic power to local governments.
Dissatisfied with centralized approaches to delivering local public services, a large number of countries are decentralizing responsibility for these services to lower-level, locally elected governments. The results have been mixed. The paper provides a framework for evaluating the benefits and costs, in terms of service delivery, of different approaches to decentralization, based on relationships of accountability between different actors in the delivery chain. Moving from a model of central provision to that of decentralization to local governments introduces a new relationship of accountability-between national and local policymakers-while altering existing relationships, such as that between citizens and elected politicians. Only by examining how these relationships change can we understand why decentralization can, and sometimes cannot, lead to better service delivery. In particular, the various instruments of decentralization-fiscal, administrative, regulatory, market, and financial-can affect the incentives facing service providers, even though they relate only to local policymakers. Likewise, and perhaps more significantly, the incentives facing local and national politicians can have a profound effect on the provision of local services. Finally, the process of implementing decentralization can be as important as the design of the system in influencing service delivery outcomes.
Sustainable and inclusive growth in emerging Asian economies requires high levels of public investment in areas such as infrastructure, education, health, and social services. The increasing complexity and regional diversity of these investment needs, together with the trend of democratization, has led to fiscal decentralization being implemented in many Asian economies. This book takes stock of some major issues regarding fiscal decentralization, including expenditure and revenue assignments, transfer programs, and sustainability of local government finances, and develops important findings and policy recommendations.
Urbanization occurs in tandem with development. Countries in Southeast Asia need to build - individually and collectively - the capacity of their cities and towns to promote economic growth and development, to make urban development more sustainable, to mitigate and adapt to climate change, and to ensure that all groups in society share in the development. This book is a result of a series of regional discussions by experts and practitioners involved in the urban and planning of their countries. It highlights urbanization issues that have implications for regional - including ASEAN - cooperation, and provides practical recommendations for policymakers. It is a first step towards assisting governments in the region to take advantage of existing collaborative partnerships to address the urban transformation that Southeast Asia is experiencing today.