Structuring Local Governance: Evidence from Health Sector Reform in Honduras

• In Event: Governance and Social Services Delivery in Developing Countries

Abstract

How do institutional reforms shape local governance systems in less developed countries? Public sector governance reforms have been a common response to the underproduction and poor quality of social services in less developed countries over the last three decades. Decentralization is especially popular in the health sector where leaders of almost every country in the world express some commitment to this type of reform in their national health plans. Yet, relatively little is known about the ways in which such reforms influence the overall structure of relationships among governmental actors and between state entities and non-state organizations. In this paper I present an original network data set of local health systems for a matched sample of 65 municipalities across Honduras and assess how decentralization reform shapes these local governance systems. I expect that transferring administrative powers to a decentralized managing organization will increase the overall connectedness of the local governance system and that this effect will be greatest in municipalities with high levels of political competition reflecting strong electoral institutions. In weakly democratic settings I expect the opposite dynamic: decentralization should lead to greater fragmentation of the local governance system due to conflict among entrenched interests over patronage. With respect to policy implementation, this work will help shed light on the conditions under which institutional reforms may engender collaboration versus conflict in the production of local social services.

Author

• Alan Zarychta, University of Chicago