TITLE:
Decentralized Governance in the Management of Urban Health Care Systems in Developing Countries
AUTHORS:
Joseph Okeyo Obosi
KEYWORDS:
Public Private Partnership, Health Governance, Health Policy, Urban Health Care Systems, Decentralization
JOURNAL NAME:
Open Journal of Political Science,
Vol.9 No.1,
January
21,
2019
ABSTRACT: Enhanced Health care services address not only one
of the key Sustainable Development Goals (SDG) which is goal No 3, but also the development strategies for most
developing countries. Good governance is critical to improving health care
systems. Many developing countries therefore have decentralized health care
systems as a way of improving good governance and as a means of attaining
improved access to and delivering quality health care services to both urban
and rural population. Decentralization involves the extent of planning,
management and decision making from national to lower levels of government.
From the 1990s the capacity of governments in developing countries to deliver
public goods and services was stretched to the extent there was dire for partnerships.
The Public Private Partnerships (PPP) therefore became fundamental in the
provision of health services under decentralization. The nature of PPP differed
from country to country and the level of decision making within each level of
government. The paper has discussed the extent to which decentralized
governance has facilitated the management of health care systems in the urban
centres through Public Private Partnership initiatives, by conducting a comparative case study analysis of
existing literature on urban health care systems under different forms of
decentralized governance in Kenya, Uganda, Ghana and India, respectively. The
study established that access to health care services differed with forms of
decentralization. Secondly, there were more public private partnerships in
devolved governments which also registered higher
improvement in access to health care services in urban centres. The paper
concluded that the more the involvement of public private partnership, the better health care services in terms of access was noted.