Is descentralization good for logistics systems? evidence on essential medicine logistics in Ghana and Guatemala
Efficient logistics systems move essential medicines down the supply chain to the service delivery point, and then to the end user. Experts on logistics systems tend to see the supply chain as requiring centralized control to be most effective. However, many health reforms have involved decentralization, which experts fear has disrupted the supply chain and made systems less effective. There is no consensus on an appropriate methodology for assessing the effectiveness of decentralization in general, and only a few studies have attempted to address decentralization of logistics systems. This paper sets out a framework and methodology of a pioneering exploratory study that examines the experiences of decentralization in two countries, Guatemala and Ghana, and presents suggestive results of how decentralization affected the performance of their logistics systems. The analytical approach assessed decentralization using the principal author's decision space' approach, which defines decentralization as the degree of choice that local officials have over different health system functions.
| Main Authors: | , , |
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| Format: | Texto biblioteca |
| Language: | eng |
| Subjects: | Descentralización administrativa, Servicios de salud, Artfrosur, |
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