Fiscal decentralization: increasing social cohesion among widely disparate territorial units

Quality of care: Measuring a neglected driver of improved health

“…21 Furthermore, Mexicans have high outof-pocket expenditures, partly due to using private health care to supplement the public system. 22 If universal health coverage fails to provide high-quality services, those who can afford it will choose to seek care outside the system, thus undermining public support forand the sustainability of -financing of universal health coverage. The quality of health-care services funded by universal health coverage needs to be monitored and if necessary, improved, to promote appropriate utilization, stable financing and better outcomes.…”

The Impact of Decentralization and New Intergovernmental Relations on Public Service Delivery: A Comparative Analysis of Colombia and Paraguay

“…Other authors (Cetrangolo & Goldschmit, 2012) are concerned with questions of efficiency in decentralized service delivery at the local level, and if it contributes to greater "social cohesion" at the territorial level. Their concern relates more to the ability of decentralization to reduce the large inequalities present in Latin America and within countries themselves.…”

“…No uniform measurement can be established, as each country has a particular fiscal arrangement, resulting from country-specific political, economic, and geographic structures (Cetrangolo & Goldschmit, 2012); but researchers generally agree that fiscal decentralization occurs when subnational governments have the capacity to decide their own expenditures (budget), have control over taxes (to collect or create new ones), and have the capacity to collect fees for services (Gargarella & Arballo, 2012). This autonomy should also apply to how monetary transfers from the central government are used at the subnational level.…”