Decentralization and Public Health Systems: Opportunities and Challenges

Abstract

This study explores the effects of governmental decentralization on public health systems, focusing on countries that have adopted federal systems in recent decades. The article examines how decentralization impacts healthcare delivery, equity, and efficiency, with examples from Brazil, Nigeria, and Switzerland. Using quantitative data analysis and qualitative interviews with health officials, researchers identify the benefits and drawbacks of decentralized health governance. The findings suggest that while decentralization can lead to more localized and tailored health policies, it may also exacerbate regional disparities. Recommendations for optimizing decentralized health systems are proposed based on cross-country comparisons.