Decentralizing supervision to attain higher productivity: the case of the ecuadorian health system |
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| Authors: | Karen L. Ruffing Howard L. Smith Richard A. Reid |
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| Affiliation: | 1. Department of Political Science , University of Arizona , Tucson, Arizona;2. Department of Health Administration , Medical College of Virginia , P.O.Box 203, MCV Station, Richmond, VA, 23298;3. Anderson Schools of Management , University of New Mexico , Albuquerque, NM, 87131 |
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| Abstract: | There is growing interest in developed and developing countries about how to best administer public programs in order to maximize the return on invested resources. This paper examines the extent to which decentralized supervision can help improve health worker productivity. Data on health workers in Ecuador are analyzed. The results suggest that local (or decentralized) supervision is conducive to higher productivity and more hours worked per day by Ecuador's health promoters. The implications for higher health status, and for improving health care in other developing countries are discussed. |
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