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Decentralisation – A Portmanteau Concept that Promises Much but Fails to Deliver? Comment on “Decentralisation of Health Services in Fiji: A Decision Space Analysis

Peckham, Stephen (2016) Decentralisation – A Portmanteau Concept that Promises Much but Fails to Deliver? Comment on “Decentralisation of Health Services in Fiji: A Decision Space Analysis. International Journal of Health Policy and Management, 5 (12). pp. 729-732. ISSN 2322-5939. E-ISSN 2322-5939. (doi:10.15171/ijhpm.2016.88) (KAR id:56206)

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http://dx.doi.org/10.15171/ijhpm.2016.88

Abstract

Decentralisation has been described as an empty concept that lacks clarity. Yet there is an enduring interest in the process of decentralisation within health systems and public services more generally. Many claims about the benefits of decentralisation are not supported by evidence. It may be useful as an organising framework for analysis of health systems but in this context it lacks conceptual clarity and particularly often ignores level context issues given the focus on a principal-agent/vertical centre/local axis or other aspects of limits on autonomy such as standards for professional practice. Both these aspects are relevant in discussing the establishment of “decentralised” health centres in Fiji. In the end decentralisation may be nothing more than a useful descriptive label that can be used in an increasingly wide range of ways but actually have little meaning in practice as an analytical concept.

Item Type: Article
DOI/Identification number: 10.15171/ijhpm.2016.88
Uncontrolled keywords: Decentralisation; Decision Space; Organisational Interdependence; Centralisation; Decision-Making; Autonomy
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Stephen Peckham
Date Deposited: 04 Jul 2016 08:28 UTC
Last Modified: 10 Jun 2019 09:57 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/56206 (The current URI for this page, for reference purposes)
Peckham, Stephen: https://orcid.org/0000-0002-7002-2614
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