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Second is the fragmentation of responsibility for health care, so that the federal government is responsible for tertiary care, the states for secondary care, and the much weaker local governments for PHC.
This self-selecting element in decision making is another consequence of the deliberate fragmentation of responsibility.
First is the fragmentation of responsibility for PHC among the three tiers of government.
But PHC workers feel they are unfairly treated, as health workers at other levels get paid more because of the fragmentation of responsibility for health care.
The themes that emerged to characterise how decentralisation influences the retention of health workers in rural communities were either attributable to fragmentation of responsibility among tiers of government or to community engagement in PHC delivery as a result of the activities of community health committees.
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Reforming of institutions, and legal reform programmes to overcome the fragmentation of responsibilities in the water and agriculture sectors.
Also, there is fragmentation of responsibilities at the level of regulatory authorities and policymakers.
Given this complexity, it is important to investigate how transitions in the chain of care are coordinated, since fragmentation of responsibilities may result in information loss and discontinuity, leading to unmet care needs for persons with dementia [ 22, 23].
The themes attributable to fragmentation of responsibilities constitute 'push' factors, whereas the themes related to community engagement are 'stick' factors (see Box 2 for the categories under each theme).
Shifting competences from the national infrastructure operators to the one-stop shops will result in a fragmentation of responsibilities and thus in an inflation of the bureaucratic apparatus.
The fragmentation of IPR protection responsibility in Italy means that for any real action to take place, officials on many levels from many offices must sign onto the process.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com