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Erschienen in:
2015 | OriginalPaper | Buchkapitel
The Politics of Participation in Health Reform
verfasst von : Amy Barnes, Garrett Wallace Brown, Sophie Harman
Erschienen in: Global Politics of Health Reform in Africa: Performance, Participation, and Policy
Verlag: Palgrave Macmillan UK
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This chapter examines how multi-sectoral and multi-level stakeholders have participated in the formation of performance-based funding (PBF) design and implementation at the global and national levels in South Africa, Tanzania, and Zambia. The chapter looks at what is meant by participation and what we know about its role in health system reform, and formal and informal mechanisms of participation at multiple levels of governance. In so doing, it demonstrates the dominance of informal mechanisms that undermine meaningful participation as they privilege elites, lock out other stakeholders from the participatory process, and maintain a positive bias towards PBF with little meaningful engagement. The chapter also explores the problems of participation fatigue and the culture of per diems and paying for participation.