Health systems research

Understanding the Impact of Decentralisation on Reproductive Health Services in Africa

Objective of the Research:

The provision of appropriate reproductive health care remains one of the major health care challenges in developing countries. The development of reproductive health service delivery is continually confronted by challenges from a changing environment an important element of which is health sector reform, particularly decentralisation, being undertaken by most governments in Africa. The general objective of this research is to make health sector decentralisation more effective in the development of appropriate reproductive health services. The general research question is: How does decentralisation affect reproductive health services? The project will compare different forms of decentralisation in two anglophone (South Africa and Uganda) and francophone (Burkina Faso and Mali) African countries to assess their impact on and importance for the development of reproductive health services.

Specific scientific and technical objectives:

1.       to identify and explain the key features and changes in reproductive health policies and services in Burkina Faso, Mali, South Africa and Uganda;

2.       to identify and explain the key features and changes in decentralised health systems in Burkina Faso, Mali, South Africa and Uganda;

3.       to document, assess and explain the extent to which the key features and changes in reproductive health policies and services noted in objective (1) are affected by the features and changes in decentralisation noted in objective (2);

4.       to identify those characteristics of decentralised health systems that are beneficial/ not beneficial/ neutral to reproductive health policies and to interpret the specific context of these features in the study countries;

5.       to conduct a comparative analysis of francophone and anglophone systems / experiences within this field;

6.       to identify lessons for policy-makers within and between the different health systems analysed;

7.       to develop national and international guidelines / recommendations which can inform national reproductive health and health sector reform policy makers and multilateral / bilateral agencies;

8.       to build the research capacity of partner research institutions in Africa;

9.       to promote co-operative and collaborative links between African and European institutions involved in the research;    

10.   to disseminate findings to a national and international audience including European and African academics, policy makers and health specialists.