Health Care Decentralization in Paraguay: Evaluation of Impact on Cost, Efficiency, Basic Quality, and Equity - Baseline Report.
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Author(s): Angeles G, Stewart JF, Gaete R, Mancini D, Trujillo A, Fowler CI
Health policymakers have considered decentralization as a potential way to improve the delivery of health services. A decentralization initiative being conducted in Paraguay allowed researchers an opportunity to analyze the impact of the decentralization process. This report presents the results of the first phase of a study of decentralization's impact on the cost, efficiency, basic quality and equity of Paraguay's health service delivery. This first phase consists of baseline measures for key performance indicators; these results present the status of the health care system in the study municipalities prior to the implementation of decentralization. This study was designed with the ultimate intent of will examining the impact of decentralization in the following four areas: cost of providing basic health care services; efficiency in the use of resources to provide health services; service quality at health facilities and from the client's perspective; and patterns of health service use and equity of health service use by the population. A Spanish-language version of this publication, "Descentralización del Sector Salud en el Paraguay: Estudio de Evaluación del Impacto en el Costo, Eficiencia, Calidad Básica, Uso, y Equidad de los Servicios Básicos de Salud - Resultados de Línea de Base," is also available.