International Journal For Multidisciplinary Research

E-ISSN: 2582-2160   •   Impact Factor: 9.24

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Political decentralization and health service delivery outcomes during shocks

Author(s) Dr. Maxwell Bruku Dapaah
Country United States
Abstract Political decentralization (PD), domestic government health spending (DGHS), financial autonomy, and accountability are considered as key elements to improving health outcomes in many countries during shocks (or pandemics). In highly decentralized systems, while PD may enhance responsiveness in health service delivery during shocks due to better information about local needs, critics highlight inefficiencies. The inefficiency is associated with the use of DGHS which is expected to increase as countries implement control measures, but spread thinly across several financially autonomous local administrations with weak state capacity and weak accountability mechanisms. Thus there is a debate about whether the information benefits (information advantage) of PD outweighs the cost (cost efficiency) during shocks and hence support better health outcomes. This study quantitatively assesses PD’s benefits and costs during H1N1 and COVID-19, finding that the information advantage far outweigh its cost. PD helped reduce fatalities through better information access, despite higher spending. These findings are useful for policy decisions on decentralization for better health service delivery.
Keywords Political decentralization, domestic government health spending, financial autonomy, accountability, health outcomes
Field Sociology > Economics
Published In Volume 7, Issue 6, November-December 2025
Published On 2025-12-14
DOI https://doi.org/10.36948/ijfmr.2025.v07i06.62549
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E-ISSN 2582-2160
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