Health reformers pursue decentralization largely to increase health sector performance, but in many cases governance and political objectives also figure importantly. The following list enumerates frequently cited objectives.
- Increase service delivery effectiveness through adaptation to local conditions and targeting to local needs.
- Improve efficiency of resource utilization by incorporating local preferences into determination of service mix and expenditures.
- Increase cost-consciousness and efficiency of service production through closer links between resource allocation and utilization.
- Increase health worker motivation through local supervision and involvement of service users in oversight, performance assessment, etc.
- Improve accountability, transparency, and legitimacy by embedding health service delivery in local administrative systems.
- Increase citizen participation in health service delivery by creating systems and procedures for involvement in planning, allocation, oversight, and evaluation.
- Increase equity of service delivery by enabling marginalized and poor groups to access health care providers and to influence decisions on service mix and expenditures.
- Increase the role of the private sector in health service delivery by separating financing of health care from service provision.