Low Decision Space Means No Decentralization in Fiji; Comment on 'Decentralisation of Health Services in Fiji: A Decision Space Analysis'

Int J Health Policy Manag. 2016;5(11):663–665

3 Pages Posted: 14 Nov 2016

See all articles by Jean-Paul Faguet

Jean-Paul Faguet

London School of Economics & Political Science (LSE) - Centre for Economic Performance (CEP)

Date Written: June 22, 2016

Abstract

Mohammed, North, and Ashton find that decentralization in Fiji shifted health-sector workloads from tertiary hospitals to peripheral health centres, but with little transfer of administrative authority from the centre. Decisionmaking in five functional areas analysed remains highly centralized. They surmise that the benefits of decentralization in terms of services and outcomes will be limited. This paper invokes Faguet’s (2012) model of local government responsiveness and accountability to explain why this is so – not only for Fiji, but in any country that decentralizes workloads but not the decision space of local governments. A competitive dynamic between economic and civic actors that interact to generate an open, competitive politics, which in turn produces accountable, responsive government can only occur where real power and resources have been devolved to local governments. Where local decision space is lacking, by contrast, decentralization is bound to fail because it has not really happened in the first place.

Keywords: Decentralization, Democracy, Local Government, Good Governance, Civil Society, Fiji

Suggested Citation

Faguet, Jean-Paul, Low Decision Space Means No Decentralization in Fiji; Comment on 'Decentralisation of Health Services in Fiji: A Decision Space Analysis' (June 22, 2016). Int J Health Policy Manag. 2016;5(11):663–665, Available at SSRN: https://ssrn.com/abstract=2868941

Jean-Paul Faguet (Contact Author)

London School of Economics & Political Science (LSE) - Centre for Economic Performance (CEP) ( email )

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