PJD 2017 Vol. 44 No. 2d
Enhancing the Philippine Legal, Regulatory, and Policy Framework for Distributed Energy Resources
PJD 2017 Vol. 44 No. 2c
Possible Effects of China's Belt and Road Initiative on Philippine Trade and Investments
PJD 2017 Vol. 44 No. 2b
Effect of Supply Chain Integration on Business Performance and Competitiveness of Philippine SMEs
PJD 2017 Vol. 44 No. 2a
Role of Subjective Perceptions and Migration Culture in the Formation of Migration Intentions: Evidence from a Rural Village in the Philippines
Publication Detail
DP 2020-04: Fiscal Decentralization and Health Service Delivery: An Assessment

The study proposes an analytical framework that examines the effects of fiscal decentralization on health service delivery using difference-in-differences (DID) method. It draws up the standard measure of the extent/degree of fiscal decentralization affecting the health sector. The findings of the DID analysis suggest that greater health decentralization has negative impact on access to hospital inpatient services and access to sanitation (toilet). It contradicts the hypothesis of the study that greater health decentralization will result in better health services. Nevertheless, it is consistent with the narrative in the literature that points out the lower province-level spending on hospitals due to mismatch between the cost of devolved hospitals and the internal revenue allotment (IRA), i.e., block grant transferred to the LGUs. Such negative effect has remained over the years because most LGUs do not have adequate health budget to maintain and upgrade devolved health facilities. Comments to this paper are welcome within 60 days from date of posting. Email

Philippine Institute for Development Studies
Authors Keywords
Cuenca, Janet S. ; health devolution; devolution; fiscal decentralization; difference-in-differences (DID) analysis;
Download PDF Number of Downloads
Published in 2020 and available in the or can be downloaded as full text Downloaded 109 times since March 17, 2020