New thinking about the management of public health services has stimulated a widespread movement for health sector reform across the world. This book examines the feasibility and desirability of common reforms in low income countries, based on in-depth case studies in Ghana, Zimbabwe, Sri Lanka, India and Thailand, and asks whether governments possess or can develop the capacities needed for these new and often complex roles. The book challenges conventional reform wisdom, and argues that reform approaches are needed that are more sensitive to the institutional characteristics of individual countries.

NIMAL ATTANAYAKE Senior Lecturer and Coordinator of the Health Economics Study Programme, Department of Economics, University of Colombo, Sri Lanka CHARLES HONGORO Medical Research Officer, Public Health Unit, Blair Research Institute, Ministry of Health and Child Welfare, Zimbabwe V.R. MURALEEDHARAN Associate Professor of Economics, Department of Humanities and Social Sciences, Indian Institute of Technology, Madras PAUL SMITHSON Health Sector Policy and Systems Adviser, Department for International Development

List of Tables List of Figures List of Boxes List of Acronyms Preface Notes on the Contributors Health Sector Reform and New Public Management The Structure and Performance of Health Systems Explanations of Performance and Reform Responses Bureaucratic Commercialisation: Decentralization of Hospital Management Increasing Government Finance: Charging the Users Government Purchase of Private Services Regulating and Enabling the Private Sector Taking Account of Capacity Reforming Health Sector Reform References Index