Does Fiscal Decentralization Improve Health Outcomes?

Does Fiscal Decentralization Improve Health Outcomes? PDF Author: David A. Robalino
Publisher: World Bank Publications
ISBN:
Category : Descentralizacion
Languages : en
Pages : 20

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Book Description
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.

Does Fiscal Decentralization Improve Health Outcomes? Evidence from a Cross-Country Analysis

Does Fiscal Decentralization Improve Health Outcomes? Evidence from a Cross-Country Analysis PDF Author: David A. Robalino
Publisher:
ISBN:
Category :
Languages : en
Pages : 14

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Book Description
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].

Fiscal Decentralization Improves Social Outcomes When Countries Have Good Governance

Fiscal Decentralization Improves Social Outcomes When Countries Have Good Governance PDF Author: Ryota Nakatani
Publisher: International Monetary Fund
ISBN:
Category : Business & Economics
Languages : en
Pages : 29

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Book Description
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.

Decentralizing Health Services

Decentralizing Health Services PDF Author: Krishna Regmi
Publisher: Springer Science & Business Media
ISBN: 1461490715
Category : Medical
Languages : en
Pages : 222

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Book Description
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

Decentralization In Health Care: Strategies And Outcomes

Decentralization In Health Care: Strategies And Outcomes PDF Author: Saltman, Richard
Publisher: McGraw-Hill Education (UK)
ISBN: 033521925X
Category : Education
Languages : en
Pages : 327

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Book Description
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.

Fiscal Decentralization

Fiscal Decentralization PDF Author: Peter Friedrich
Publisher:
ISBN: 9783830507208
Category :
Languages : en
Pages : 262

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Book Description


On the Measurement and Impact of Fiscal Decentralization

On the Measurement and Impact of Fiscal Decentralization PDF Author: Robert D. Ebel
Publisher: World Bank Publications
ISBN:
Category : Central-local government relations
Languages : en
Pages : 32

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Book Description


Fiscal Decentralization and Local Finance in Developing Countries

Fiscal Decentralization and Local Finance in Developing Countries PDF Author: Roy Bahl
Publisher: Edward Elgar Publishing
ISBN: 1786435306
Category : Business & Economics
Languages : en
Pages : 512

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Book Description
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.

Fiscal Decentralization and the Efficiency of Public Service Delivery

Fiscal Decentralization and the Efficiency of Public Service Delivery PDF Author: Moussé Sow
Publisher: International Monetary Fund
ISBN: 1475564031
Category : Business & Economics
Languages : en
Pages : 30

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Book Description
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.

Regional Integration in West Africa

Regional Integration in West Africa PDF Author: Eswar Prasad
Publisher: Brookings Institution Press
ISBN: 0815738544
Category : Business & Economics
Languages : en
Pages : 203

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Book Description
" Assessing the potential benefits and risks of a currency union Leaders of the fifteen-member Economic Community of West African States (ECOWAS) have set a goal of achieving a monetary and currency union by late 2020. Although some progress has been made toward achieving this ambitious goal, major challenges remain if the region is to realize the necessary macroeconomic convergence and establish the required institutional framework in a relatively short period of time. The proposed union offers many potential benefits, especially for countries with historically high inflation rates and weak central banks. But, as implementation of the euro over the past two decades has shown, folding multiple currencies, representing disparate economies, into a common union comes with significant costs, along with operational challenges and transitional risks. All these potential negatives must be considered carefully by ECOWAS leaders seeking tomeet a self-imposed deadline. This book, by two leading experts on economics and Africa, makes a significant analytical contribution to the debates now under way about how ECOWAS could achieve and manage its currency union, andthe ramifications for the African continent. "