Decentralisation and Health Systems Performance in Developing Countries

This article attempts to elucidate the intricacies of primary health care delivery in Nigeria. Among myriad complexities, the central proposition made herein is that the absence of an effective regulatory and enforcement framework in developing countries results in a prominent informal decision space. The findings show that the prominence of an informal decision space compromises the objectives of an information-based public health system. The article concludes that decentralisation in developing countries must have a coordinated top-down and bottom-up development component for it to be effective in improving the performance of primary health systems. One of the implications of the study is that researching decentralised healthcare delivery requires analytical models which are able to illuminate the complexities of local accountability in developing countries. The study also reveals the need to further research the dynamics of democratic decentralisation in developing countries as this goes beyond administrative structures but involve socio-cultural institutions.

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Decentralisation and Health Systems Performance in Developing Countries

Healthcare Delivery Reform and New Technologies ◽

10.4018/978-1-60960-183-6.ch003 ◽

2011 ◽

pp. 29-54

Author(s):

Adebusoye A. Anifalaje

Keyword(s):

Developing Countries ◽

Health Systems ◽

Care Delivery ◽

Healthcare Delivery ◽

Analytical Models ◽

Top Down ◽

Decision Space ◽

Primary Health ◽

Health Systems Performance ◽

Administrative Structures

This article attempts to elucidate the intricacies of primary health care delivery in Nigeria. Among myriad complexities, the central proposition made herein is that the absence of an effective regulatory and enforcement framework in developing countries results in a prominent informal decision space. The findings show that the prominence of an informal decision space compromises the objectives of an information-based public health system. The article concludes that decentralisation in developing countries must have a coordinated top-down and bottom-up development component for it to be effective in improving the performance of primary health systems. One of the implications of the study is that researching decentralised healthcare delivery requires analytical models which are able to illuminate the complexities of local accountability in developing countries. The study also reveals the need to further research the dynamics of democratic decentralisation in developing countries as this goes beyond administrative structures but involve socio-cultural institutions.

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Health Systems Performance

Das Gesundheitswesen ◽

10.1055/s-2005-920593 ◽

2005 ◽

Vol 67 (07) ◽

Author(s):

M Elhewaihi

Keyword(s):

Health Systems ◽

Health Systems Performance

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Clinical Decision Support System Adoption & Implementation in African Health Systems: A SWOT Analysis. (Preprint)

10.2196/preprints.32498 ◽

2021 ◽

Author(s):

Victoria Oluwafunmilola Kolawole

Keyword(s):

Developing Countries ◽

Decision Support ◽

Health Systems ◽

Clinical Decision Support ◽

Clinical Decision Support System ◽

Swot Analysis ◽

Clinical Decision ◽

Developed Countries ◽

Evidence Based ◽

African Health

BACKGROUND The clinical decision support system (CDSS) has been an important achievement of health technology in the 21st century. In developed countries, it has transformed the way health services are being delivered and has shown to be a tool that reduces medical errors and misdiagnoses in Healthcare. However, CDSS remains underutilized in developing countries in Africa. OBJECTIVE This study aims to review the literature to improve our understanding of the “strengths, weaknesses, opportunities and threats (SWOT)” associated with CDSS implementation in African health systems. METHODS This study included a literature review conducted in PubMed with a total of 19 articles between the year 2010 to date (past 10years) reviewed for key themes and categorized into one of 4 possible areas within the SWOT analysis. RESULTS Articles reviewed showed common strengths of efficiency at the workplace, Improved healthcare quality, benefits in developed countries, good examples of evidence-based decision making. unreliable electric power supply, inconsistent Internet connectivity, clinician's limited computer skills, and lack of enough published evidence of benefits in developing countries are listed as a weakness. The opportunities are high demand for evidence-based practice in healthcare, a strong demand for quality healthcare, growing interest to use modern technologies. The common threats identified are government policy, political instability, low funding and resistance of use by providers. CONCLUSIONS There’s the need to work on the technical, organizational and financial barriers to ensure high adoption and implementation of the CDSS in African Health systems. Also, the lag on the knowledge available on its impact in developing countries must be worked on by supporting more studies to add to the body of knowledge.

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Health Systems in Developing Countries

Population and Health in Developing Countries ◽

10.1007/978-94-007-6793-5_7 ◽

2013 ◽

pp. 119-139

Author(s):

Maryse Gaimard

Keyword(s):

Developing Countries ◽

Health Systems

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Global flows

Health Equity in a Globalizing Era ◽

10.1093/oso/9780198835356.003.0009 ◽

2019 ◽

pp. 192-219

Author(s):

Ronald Labonté ◽

Arne Ruckert

Keyword(s):

Health Care ◽

Developing Countries ◽

Health Systems ◽

Medical Tourism ◽

Health Workers ◽

Skilled Labour ◽

Private Investments ◽

Market Opportunities ◽

Health Worker Migration ◽

High Disease Burden

Health systems rely upon two groups of people: health workers and patients. In recent decades both groups have been on the move globally, with the creation of internationalized labour market opportunities (the hunt for skilled labour in the case of health workers) and private investments in high-end health care on lower-cost developing countries (one of the key incentives for patients seeking care outside of their own country, for uninsured or under-insured services). Both flows raise a number of health equity concerns. Health worker migration can pose undue hardships on low-resource, high-disease burden countries who lose their workers to richer nations, creating a ‘perverse subsidy’ of poor to rich. With medical tourism, private, fee-paying foreign patients in poorer countries could ‘crowd out’ access to care for domestic patients in those countries, while potentially returning with drug resistant infections or complications burdening their home country’s health systems.

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