New thinking about the management of public health services has stimulated a widespread movement for health sector reform across the world. This book examines the feasibility and desirability of common reforms in low income countries, based on in-depth case studies in Ghana, Zimbabwe, Sri Lanka, India and Thailand, and asks whether governments possess or can develop the capacities needed for these new and often complex roles. The book challenges conventional reform wisdom, and argues that reform approaches are needed that are more sensitive to the institutional characteristics of individual countries.

'This book straddles two centuries. On the one hand, it looks at the health reform movement that marked the last decade of the twentieth century. On the other, it looks forward to some of the new ideas that will guide health systems development in the first years of the twenty-first century...this major piece of work focuses on the central issue in the health reform debate: the roles and capabilities of governments. The way such roles are redifined and such capabilities enhanced will determine the future performance of health systems throughout the world.' - Julio Frenk, Director, Evidence and Information for Policy Cluster, World Health Organization

'This is the first book I have encountered to challenge the conventional wisdom on health sector reform in developing countries in an integrated and comprehensive way, rooting the critical analysis of theoretical approaches in country experience. It highlights the dangers of uncritically transplanting developed country strategies to developing countries. The authors offer important new insights into how to reform the current health sector reform agenda, particularly in relation to adopting more realistic and gradual approach to reform and rethinking the role of government in the health sector. It should be read by anyone actively involved in designing and implementing health sector reform in developing countries, including government officials, international organisation technicians and academics who provide technical assistance. It is also extremely valuable to post-graduate students in the fields of international health, health economics and health policy.' - Professor Di McIntyre, Director, Health Economics Unit, University of Cape Town

'The health sector in many developing countries face twin institutional and policy reform challenges to increase effectivenes, coverage and quality of services while enhancing resource use efficiencies in both public and private sectors. The role of the government is critical in ensuring that institutions and policy reform processes are effective in implementing reforms. However, there is very little understanding of these challenges and processes - particularly relating to institutional aspects. Given the public sector institutional context and social and economic realities in developing countries, the tasks are multifaceted and complex. Through five country case studies of Ghana, Zimbabwe, Sri Lanka, India and Thailand, the book examines a number of these challenges. The case studies broaden our understanding of approaches to manage reform processes in the health sector. This is an important contribution in the area of managing and implementing health reform strategies and required reading for policy makers managing health sector reform.' - Professor Ramesh Bhat, Indian Institute of Management, Ahmedabad

Autorentext
NIMAL ATTANAYAKE Senior Lecturer and Coordinator of the Health Economics Study Programme, Department of Economics, University of Colombo, Sri Lanka CHARLES HONGORO Medical Research Officer, Public Health Unit, Blair Research Institute, Ministry of Health and Child Welfare, Zimbabwe V.R. MURALEEDHARAN Associate Professor of Economics, Department of Humanities and Social Sciences, Indian Institute of Technology, Madras PAUL SMITHSON Health Sector Policy and Systems Adviser, Department for International Development

Inhalt
List of Tables List of Figures List of Boxes List of Acronyms Preface Notes on the Contributors Health Sector Reform and New Public Management The Structure and Performance of Health Systems Explanations of Performance and Reform Responses Bureaucratic Commercialisation: Decentralization of Hospital Management Increasing Government Finance: Charging the Users Government Purchase of Private Services Regulating and Enabling the Private Sector Taking Account of Capacity Reforming Health Sector Reform References Index