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Decentralization of Health and Education in Developing Countries: A Quality-Adjusted Review of the Empirical Literature

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  • Anila Channa
  • Jean-Paul Faguet

Abstract

We review empirical evidence on the ability of decentralization to enhance preference matching and technical efficiency in the provision of health and education in developing countries. Many influential surveys have found that the empirical evidence of decentralization's effects on service delivery is weak, incomplete and often contradictory. Our own unweighted reading of the literature concurs. But when we organize the evidence first by substantive theme, and then - crucially - by empirical quality and the credibility of its identification strategy, clear patterns emerge. Higher quality evidence indicates that decentralization increases technical efficiency across a variety of public services, from student test scores to infant mortality rates. Decentralization also improves preference matching in education, and can do so in health under certain conditions, although there is less evidence for both. We discuss individual studies in some detail. Weighting by quality is especially important when evidence informs policy-making. Firmer conclusions will require an increased focus on research design, and a deeper examination into the prerequisites and mechanisms of successful reforms.

Suggested Citation

  • Anila Channa & Jean-Paul Faguet, 2012. "Decentralization of Health and Education in Developing Countries: A Quality-Adjusted Review of the Empirical Literature," STICERD - Economic Organisation and Public Policy Discussion Papers Series 038, Suntory and Toyota International Centres for Economics and Related Disciplines, LSE.
  • Handle: RePEc:cep:stieop:038
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    1. repec:eee:wdevel:v:96:y:2017:i:c:p:326-342 is not listed on IDEAS
    2. Septimiu-Rare? SZABO, 2013. "Decentralisation In The Context Of Multi-Level Governance: Study Case - Romania," Proceedings of Administration and Public Management International Conference, Research Centre in Public Administration and Public Services, Bucharest, Romania, vol. 9(1), pages 92-103, June.
    3. Castro, Marcelo Araújo & Mattos, Enlinson & Patriota, Fernanda, 2016. "Spatial spillovers and political coordination in public health provision," Textos para discussão 417, FGV/EESP - Escola de Economia de São Paulo, Getulio Vargas Foundation (Brazil).
    4. Cavalieri, Marina & Ferrante, Livio, 2016. "Does fiscal decentralization improve health outcomes? Evidence from infant mortality in Italy," Social Science & Medicine, Elsevier, vol. 164(C), pages 74-88.
    5. Mattos, Enlinson & Ribeiro, Fernanda Patriota Salles, 2015. "Unconditional transfers goes to health? Evidence from Brazilian municipalities," Textos para discussão 376, FGV/EESP - Escola de Economia de São Paulo, Getulio Vargas Foundation (Brazil).
    6. Khan, Qaiser & Faguet, Jean-Paul & Ambel, Alemayehu, 2017. "Blending Top-Down Federalism with Bottom-Up Engagement to Reduce Inequality in Ethiopia," World Development, Elsevier, vol. 96(C), pages 326-342.
    7. Julien Jacqmin & Mathieu Lefebvre, 2017. "Fiscal decentralization and the performance of higher education institutions: the case of Europe," Working Papers of BETA 2017-31, Bureau d'Economie Théorique et Appliquée, UDS, Strasbourg.
    8. repec:rom:campco:v:9:y:2013:i:1:p:92-103 is not listed on IDEAS

    More about this item

    Keywords

    Decentralization; School-Based Management; Education; Health; Service Delivery; Developing Countries; Preference Matching; Technical Efficiency;

    JEL classification:

    • H41 - Public Economics - - Publicly Provided Goods - - - Public Goods
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • H77 - Public Economics - - State and Local Government; Intergovernmental Relations - - - Intergovernmental Relations; Federalism
    • O1 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development

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