Health financing changes in the context of health care decentralization: the case of three Latin American countries.
OBJECTIVE
The results of an evaluative longitudinal study, which identified the effects of health care decentralization on health financing in Mexico, Nicaragua and Peru are presented in this article.


METHODS
The methodology had two main phases. In the first, secondary sources of data and documents were analyzed with the following variables: type of decentralization implemented, source of financing, funds for financing, providers, final use of resources, mechanisms for resource allocation. In the second phase, primary data were collected by a survey of key personnel in the health sector.


RESULTS
Results of the comparative analysis are presented, showing the changes implemented in the three countries, as well as the strengths and weaknesses of each country in matters of financing and decentralization.


CONCLUSIONS
The main financing changes implemented and quantitative trends with respect to the five financing indicators are presented as a methodological tool to implement corrections and adjustments in health financing.
Arredondo
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Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México. arrendon@insp3.insp.mx
Parada
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D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration / Q000639:trends; D005378:Financial Support; D015276:Health Care Rationing; D018166:Health Care Reform / Q000191:economics*; D008137:Longitudinal Studies; D008800:Mexico; D009527:Nicaragua; D010568:Peru