Decentralization and accountability in the health sector from an international perspective: What are the choices?

This article reviews alternative decentralization policies for the health sector. It discusses the forms that decentralization can take, illustrating these with country examples. It then considers the choice of levels in a decentralization policy and the desirability of the creation of health boards or authorities. Decentralized authorities can be given differing levels of responsibility for different tasks: those considered here are revenue raising, policy‐making and planning, resource allocation, funding of service provision and interagency and intersec‐toral coordination. The article concludes by considering some criteria for evaluating decentralization approaches.