Support Local Government
Worldwide trends toward government decentralization present a significant opportunity to enhance the equitable delivery of health services in urban areas. As local officials are most easily accessed by community leaders and most likely to understand the context in which services must be delivered, there are many potential benefits to placing service delivery in the hands of local governments. However, there is concern that local government officials may not have the skills needed to effectively and equitably manage service delivery especially without central government support.
As such decentralized programs should support the education of local governments on local public health needs, prioritization and strategic management of health service delivery, storage and distribution of pharmaceuticals, and low cost interventions that can support marginalized populations in their communities. Also regardless of the level of decentralization, a clear understanding of the roles and responsibilities of different layers and different offices of government is important to effectively deliver health services to the urban poor. Relationships between the central, state and local governments must be examined as should the relationship between local government environment, infrastructure and health offices.
One innovative USAID-supported program working to build local government's ability to take on urban health challenges among small municipalities in Bangladesh is being implemented by the NGO Concern.
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