Abstract

GIMENEZ-CABALLERO, Edgar; RODRIGUEZ, José Carlos  and  PERALTA, Néstor. Decision spaces on health decentralization in Paraguay. Mem. Inst. Investig. Cienc. Salud [online]. 2016, vol.14, n.3, pp.44-51. ISSN 1812-9528.  https://doi.org/10.18004/mem.iics/1812-9528/2016.014(03)44-051.

Although decentralization it is established by the law, it develops slowly in Paraguay. This article evaluates public health decentralization from the conceptual framework of Decision Spaces where the major decision maker is the Ministry of Health while its Agents are Health establishments and Councils. Five hundred eleven people from the public health system were interviewed. The decentralized functions studied were: management of financial and human resources, service management by rules of organization and direction, access rules management to improve accessibility and social participation in relation to health services. In this study, the departmental capitals of the Eastern Region and the capital of the department of President Hayes in the Western Region were included. The decentralization of the Paraguayan public health was between Minimum to Incipient. The greater decentralization was in the organization function, suggesting a local option in favor of the process, followed by direction, access, human resources and participation. The lower decentralization in Finances can be related to the chronic lack of fiscal resources of the state.

Keywords : Decentralization; Public Health; Health Councils; Paraguay; Decision Spaces.

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