Contracting for health services: an evaluation of recent reforms in Nicaragua.

  title={Contracting for health services: an evaluation of recent reforms in Nicaragua.},
  author={William Jack},
  journal={Health policy and planning},
  volume={18 2},
Nicaragua has embarked on a reform of the way in which publicly provided medical care is organized and financed. A principal feature of the reforms includes a decentralization of decision-making authority coupled with an increase in local accountability. Local decision-making authority has been increased by allowing managers more freedom to allocate inputs. Accountability has been strengthened by stipulating what is expected of hospitals and health centres in the form of performance agreements… CONTINUE READING

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