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Health Policy |
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Priorities in Health |
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Projects |
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Documents |
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Priority Countries |
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| Priorities in Health | ||
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Health sector reforms and decentralisation
Increasing resources and efforts are currently being channelled towards “health sector strengthening” even by Global Health Initiatives and the Global Fund to fight AIDS, Tuberculosis and Malaria, despite these agencies initial disease-specific focus. The search for more accountable, functioning health systems isn’t new. Many developing and transition countries have long since embarked upon wide-reaching reforms. Health Sector Reform takes place within a broader public sector reform context, parallel to political reforms such as decentralisation and financial reforms. In many countries, these reforms are taking place in contexts of extremely limited resources and at a much faster speed than similar processes in most Western countries, thus making their implementation a considerable challenge.Whilst each country process has its own characteristics, overall an increased emphasis on primary health care, priority setting in the allocation of resources, public accountability, and monitoring and evaluation can be observed.
Decentralisation can take many forms and is seldom an “either/or” issue with different functions within a system – planning, management of finances, service delivery often at varying stages thereof. Experience shows that when decentralisation has been pursued for technical reasons in the health sector, it has been a major component of performance improvement efforts. However, where political and financial motives have driven the decentralisation process, the health sector has had to develop coping strategies to maintain services and progress toward health objectives. Establishing the objectives of a health care system, and the means by which a health system will deliver improved health to the population, are major questions that must be answered in order to give direction to the reform of the health system. Political, technical and economic considerations all play a role in health service management. Economic thinking can provide a relevant framework for the examination of key issues such as cost-sharing, payment schemes, provider competition, incentive mechanisms, contracting, privatisation etc. |
| Related SDC Projects |
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Strengthening Health Research capacities in Support Health sector Reform in Tajikistan
(Related Country:
Tajikistan)
The overall goal of the project is to strengthen the National Health Research System.
Firstly the project raises awareness for the need of information and evidence about health issues. Secondly, it contributes to the human capital development of Tajik young researchers and health professionals.
 Project Documentation
Health Policy Dialogue in Tajikistan
(Related Country:
Tajikistan)
In order to improve the effectiveness of the ongoing Health Sector Reform SDC is supporting the Ministry of Health for a limited period of two years with the establishment of a "Health Sector Reform - Secretariat".
Project Documentation
Community and Basic Health Project
(Related Country:
Tajikistan)
To provide coherence to its ongoing health programmes, and moreover to better integrate health care reform projects in Tajikistan, the SDC found it rational to co-fund the World Bank "Community and Basic Health Project" (CBHP) which is seen also as a ground work for a future Sector Wide Approach (SWAP) in health sector.
Project Documentation
Remssy - Emergency Services
(Related Country:
Romania)
The Romanian health system is still undergoing profound transformations and does not yet provide comprehensive health services. In this situation access to emergency care is of utmost importance to the general population. For this reason, starting with 1994, Swiss cooperation has been deeply involved in the reform of the emergency medical services in Romania.
Project Documentation
RoNeonat - Modernising Neonatology Services
(Related Country:
Romania)
Infant and birth mortality rates in Romania are among the highest in Europe. Therefore, the Romanian health authorities and Swiss cooperation have agreed to implement together the Romanian-Swiss Neonatology Project (RoNeoNat) with the aim of substantially reducing infant and birth mortality rates in Romania.
Project Documentation
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| SDC Documents |
| Show archived Items (1) |
| Resources |
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ID21 Health: Health systems and economics
Journal: Health Policy and Planning
Health Systems Resource Guide
WHO information on Health Sector Reform
MSH: Decentralization Planning Tools
Decentralisation in Asian health sectors: friend or foe?
Decentralization and Health System Reform
Enabling access for all to the political system |
| Basics |
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The World Health Report 2000: Health Systems. Improving Performance
The World Health Report 2003: "Shaping the Future" |