The decentralisation of the health sector in Colombia seen from a multiple level perspectives

This article analyses the characteristics of Institutional Development (m) and Community Participation (CP) as the main components of decentralisation of the health sector in Colombia. This analysis is framed in the context of health sector reforms that seek to improve the provision of health services. Decentralisation is understood as a public policy, which interacts strongly with the political, social, economic and administrative environment. The study involved three case studies and the perspective of the regional and national decision-makers in which qualitative and quantitative data were gathered and processed. The findings suggest that the three municipalities have progressed in some aspects of the decentralisation of the health sector, but they do not have an integrated development Of ID and CP. The political system has played an important role in this process, in which the patronage system influences the quality of the staff and the whole process. The mixture of decentralisation and privatisation has also created conflicts in the provision of services.