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This paper proposes a framework for examining the process by which government consideration and adoption of new vaccines takes place, with specific reference to developing country settings. The cases of early Hepatitis B vaccine adoption in Taiwan and Thailand are used to explore the relevance of explanatory factors identified in the literature as well as(More)
Developing countries that were early, enthusiastic adopters of primary health care often developed an extensive - but eventually dilapidated and under utilized - network of public clinics at the grassroots. As paradigms and investment patterns of health sector reform have shifted, the question of what role these public clinics can meaningfully play, and how(More)
The study of the health workforce has gained in prominence in recent years, as the dynamic interconnections between human resource issues and health system effectiveness have come into sharper focus. This paper reviews lessons relating to strategic management challenges emerging from the growing literature in this area. Workforce issues are strategic: they(More)
Decentralization occupies an important space in debates over public-sector reform in doi moi Vietnam. This paper assesses the changing distribution of roles, responsibilities and resources across levels of government over the past decade. Vietnam is incrementally transfering greater administrative and fiscal responsibilities to the provincial level. In(More)
Health authorities in developing countries must often cope with rapid changes in the administrative, policy and socioeconomic contexts in which they work. Changes in this external environment have important implications for the roles that health planners can effectively play and the leverage they exercise throughout the system. This paper examines the(More)
SUMMARY International donors, long-standing supporters of decentralization reforms in developing countries, often face the challenge of aligning program assistance to the great variety of country governance settings in which many operate. This paper presents a framework for assessing the implications of governance and institutional context for a range of(More)
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