An Integrity perspective on the Decentralization of the health sector in Colombia

Abstract

ABSTRACT: This study analyzes the decentralization of the health sector in Colombia by exploring the characteristics of Institutional Development and Community Participation and their relationship with the socio-economic conditions of Colombian municipalities, as well as the administrative and political issues that affect the implementation processes at the municipal level. The analysis is framed in the context of health sector reform, and decentralization is understood as a public policy which interacts strongly with the political, social, economic and administrative environments. The methodology involves qualitative and quantitative methods; three case studies and a survey of 91 municipalities were carried out. The findings from different sources and methods suggest that the level of progress in the health sector is not consistent with the socio-economic categories in which the municipalities have been classified. This is closely related to the quality of the staff working within the health sector, which is, in turn, connected with the patronage system and the political Will of the municipal, regional and national governments.