This book presents a new multi-disciplinary framework for developing and analyzing health sector reform plans in a wide variety of national circumstances. By focusing on the health care system as a means to an end, the authors provide tools and techniques for designing reforms that will produce real improvements in health sector performance. Integrating economic analysis, political strategy, managerial considerations, and ethical concerns, they offer practical guidance for dealing with the many difficult challenges of health sector reform. The book's methods and approach are based on the authors' extensive experience as researchers, advisors, and teachers of health care reform around the world. Rather than taking a one-size-fits-all approach, they stress the need for each nation to develop plans that are consistent with its administrative capacities, economic circumstances, political realities, and social values. The first half of the book reviews general methods for defining problems in an ethically self-reflexive way, diagnosing the causes of those problems, developing relevant policies, and marshalling political support. The second half examines five health sector reform "control knobs" - arenas in which government can act to improve the performance of the health system. Each control knob - financing, payment, organization, regulation, and behavior - is extensively discussed to inform readers about available options and the lessons of international experience. This book draws together an exceptionally wide range of analytical methods and practical experience, and fills a major gap in the literature on health reform and health systems for lower and middle-income nations. It will be of value to policymakers, administrators, consultants, academics, and students alike.
