Does decentralization of health systems translate into decentralization of authority? A decision space analysis of Ugandan healthcare facilities.

ABSTRACT: Since the 1990s, following similar reforms to its general politico-administrative systems, Uganda has decentralized its public healthcare system by shifting decision-making power away from its central Ministry of Health and towards more distal administrative levels. Previous research has used decision space-the decision-making autonomy demonstrated by entities in an administrative hierarchy-to measure overall health system decentralization. This study aimed to determine how the decision-making autonomy reported by managers of Ugandan healthcare facilities (de facto decision space) differs from that which they are allocated by official policies (de jure decision space). Additionally, it sought to determine associations between decision space and indicators of managerial performance. Using q

SUBMITTER: Chen J 

PROVIDER: S-EPMC8505862 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature