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Introduction

Health system decentralization has been a growing trend in many countries around the world as a means to improve the equity and efficiency of public health service delivery. By transferring decision-making power and resources from the central government to local authorities, decentralization aims to bring health services closer to communities, enhance responsiveness to local needs, and improve overall health outcomes. However, the impact of decentralization on equity and efficiency in public health service delivery is not well understood. This thesis seeks to analyze the effects of health system decentralization on equity and efficiency, with a focus on how decentralization influences access to services, quality of care, and health outcomes among different population groups.

Table of Contents

Chapter 1: Introduction
1.1 Introduction
1.2 Background of study
1.3 Problem Statement
1.4 Objective of study
1.5 Limitation of study
1.6 Scope of study
1.7 Significance of study
1.8 Structure of the Thesis
1.9 Definition of terms

Chapter 2: Literature Review
2.1 Evolution of health system decentralization
2.2 Theoretical frameworks for analyzing decentralization
2.3 Impact of decentralization on equity in health service delivery
2.4 Impact of decentralization on efficiency in health service delivery
2.5 Factors influencing the success of decentralization initiatives
2.6 Challenges and limitations of decentralization
2.7 International experiences with health system decentralization
2.8 Empirical studies on the effects of decentralization on health outcomes
2.9 Critical analysis of existing literature
2.10 Conceptual framework

Chapter 3: Research Methodology
3.1 Research design
3.2 Study setting
3.3 Data collection methods
3.4 Sampling strategy
3.5 Data analysis techniques
3.6 Ethical considerations
3.7 Study limitations
3.8 Validity and reliability of findings

Chapter 4: Discussion of Findings
4.1 Overview of study findings
4.2 Analysis of the impact of decentralization on equity in health service delivery
4.3 Analysis of the impact of decentralization on efficiency in health service delivery
4.4 Comparison of findings with existing literature
4.5 Implications for policy and practice
4.6 Recommendations for future research

Chapter 5: Conclusion and Summary
5.1 Summary of key findings
5.2 Contribution to knowledge
5.3 Policy implications
5.4 Limitations of the study
5.5 Recommendations for future research
5.6 Conclusion

Thesis Overview

Health system decentralization is a complex process that involves shifting decision-making authority and resources from the central government to local authorities. While the rationale behind decentralization is to improve the equity and efficiency of public health service delivery, its impact on health outcomes remains unclear. This thesis aims to address this gap in the literature by analyzing the effects of decentralization on equity and efficiency in public health service delivery.

The literature review will provide a comprehensive overview of the evolution of health system decentralization, theoretical frameworks for analyzing decentralization, and empirical studies on its impact on equity and efficiency. Building on existing literature, the research methodology will outline the study design, data collection methods, and analytical techniques used to investigate the research questions. The discussion of findings will present an in-depth analysis of the impact of decentralization on equity and efficiency, drawing on data collected from the study.

In conclusion, this thesis will offer insights into the implications of health system decentralization for policy and practice, identify areas for future research, and contribute to the existing knowledge base on the subject. Through a rigorous analysis of the effects of decentralization on public health service delivery, this study aims to inform decision-makers on strategies to enhance equity and efficiency in health systems.

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