FISCAL DECENTRALIZATION AND HEALTH SERVICE DELIVERY: THE PHILIPPINE CASE

Abstract

More than 25 years into the implementation of the Local Government Code of 1991, it is inconclusive whether fiscal decentralization indeed improves health service delivery in the Philippines. In this regard, the thesis documents the health devolution experience in the country and it draws lessons and insights that are critical in assessing the effects of health devolution and in crafting future public policies. Also, it proposes an analytical framework that examines the effects of fiscal decentralization on health service delivery using difference-in-differences (DID) method. Further, it analyzes the efficiency implications of fiscal decentralization using stochastic frontier analysis (SFA). The findings of DID analysis suggest that greater health decentralization has negative effect on access to hospital inpatient services and access to sanitation. On the other hand, the findings of SFA lend empirical evidences to the inefficiencies in health service delivery.