Optimising decentralisation for the health sector by exploring the synergy of decision space, capacity and accountability

10 January, 2019

Dear HIFA Colleagues,

We are pleased to share this new publication in Health Research Policy and Systems where we build on the conceptual synergy of decision space, capacities and accountability and apply it to analyse health sector decentralisation/devolution in the Philippines. The article is open access: https://doi.org/10.1186/s12961-018-0402-1

This synergy was initially introduced to the literature by Prof. Thomas Bossert of Harvard University through his work that analysed health sector decentralisation in Pakistan. We drew from Bossert's work and explored the application of the synergy for the Philippines where the government health sector was devolved to local governments in 1992. While decentralisation has been vigorously promoted in the last three decades to bring decision-making closer to local levels, we argue that it will be optimal in strengthening health systems if the transfer of authority is also accompanied by building capacities at local levels and enhancing accountability to ensure good decision-making. We hope that you will find this paper useful in understanding how to make decentralisation work in favor of strengthening health systems in various settings.

Thank you and best wishes,


Harvy Joy Liwanag, MD, MBA

PhD Candidate in Epidemiology

Swiss Tropical and Public Health Institute (Swiss TPH)

Basel, Switzerland

HIFA profile: Harvy Joy Liwanag is a PhD Candidate at the Swiss Tropical and Public Health Institute in the Philippines. Professional interests: Health systems research. harvy.liwanag AT unibas.ch