Health Sector Reform

Health sector reform is a ‘significant and intentional effort to improve the performance of the health care system’ (Roberts, Hsiao, Berman & Reich, 2004). The authors use the term depending on what they propose defines a health care system, which includes immediate performance results (efficiency, quality, and accessibility) and performance goals (health status of population, citizens’ satisfaction, protection against financial risk). Health sector reform in Jamaica started in the 1970s. There are many elements of health sector reform, however, this paper focuses on decentralization and cost recovery as two (2) elements of health sector reform in Jamaica along with one (1) advantage and disadvantage on the nursing profession.
In many developing countries decentralization is a significant component of health care reform. Decentralization is an emerging theme within the health sector which began in 1996 with the creation of Regional Health Authorities. It is suggested by many advocates that providing greater authority to local decision-making bodies can improve both the technical and allocative efficiency with which health care systems operate. The island of Jamaica has undertaken the process of decentralizing the administration of healthcare as a part of nationwide structural reform.
The extent to which technical health expertise is involved in the design and planning stage of the decentralization process varies in many countries and often impacts staff equity, worker motivation and performance (Kolehmainen, 2004). Managers are charged with the responsibility of ensuring that the employees have the necessary resources and tools to do their job and should be able to motivate staff, as well as employing suitable personnel which will impact positively on performance and productivity. In poor resource settings where there are limitations it would require innovations and sometimes sacrifices for managers to achieve these objectives.
Though decentralization seems...