| المستخلص: |
Health services play an important role in development, through affecting economic growth, human development and poverty. The state has a major role in the health services sector, especially in developing countries. This role is justified by several reasons including equity and market failure. However, there are several deficiencies that negatively affect the role of the state in the health services sector in developing countries. Egypt is no exception. The deficiencies include limited resources, inefficiency, bad quality and inequality in distributing public health services. This in turn raises the question about the health sector reform. Fiscal decentralization has become an increasingly common strategy for health sector reform. Thus, the objective of this study is to evaluate the role of the state in the health services sector, the need for reform and the fiscal decentralization as a reform strategy to address the deficiencies in the public provision of health services. The study consists of six parts. Part one analyzes the role of the health services in development. Parts two and three evaluate the role of the state in the health services sector, the need for re¬forming the public health services in developing countries and fiscal decentralization as a reform strategy. Parts four and five cover the role of the state in the health services sector in Egypt and the deficiencies negatively affecting this role. Part six analyzes the mechanisms through which fiscal decentralization can improve the public provision of health services in Egypt and the potential barriers to implementing this strategy.
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