Abstract

The current promoters of the decentralization of health services affirm that its implementation will improve the quality, equity and efficiency of health systems and at the same time will increase users' satisfaction. Additionally, those who advocate decentralization believe that it will facilitate community participation in health decisionmaking, and as a result it will strengthen the democratic process. In this study we discuss first the lack of consensus regarding the meaning of decentralization and the difficulties of measuring the degree of decentralization of a health system. We also identify the actors who have formulated the above hypotheses, examine the reasons behind its formulation, and analyze if the outcome of the decentralization of the Latin American health services confirm the hypotheses.