The key components of this approach are the reinforcement of local capacities, de-centralization of activities, and community-based surveillance and follow-up.
Most existing studies analyze government behavior from a central-local perspective, looking at centralization and decentralization of state power, such as the analysis of the unification of the central government and the flexibility of the local government (Zhou 2011), administrative subcontract theory (Zhou 2014), and so on.
"And how formal you make the system requirements for affiliation will vary as each group of hospitals struggles with this tension -- centralization versus local responsiveness".
The centralization of local integration policies has occurred in both cases, albeit in a different way and using different strategies.
Nevertheless, its main application is related to the issue: centralization against local powers, which is another aspect of the spatial dimension of politics.
Egypt is facing great challenges regarding its economy in general, and rural development (RD) – including agriculture – in particular, such as: the extreme poverty among small-scale farmers; lack of coordination and integration between various stakeholders; complicated local administration system and centralization; and reduced governmental investments.
The office of Borough President was created in the consolidation of 1898 to balance centralization with local authority.
When it is necessary to work in different ways because of demographical changes, IMC has some clear advantages over other possible solutions, such as territorial reorganization and centralization of local tasks to upper level government.
Because of the incentives that faced political actors and the controversial nature of major hospital reforms, the removal of local politicians and the centralization of ownership did not necessarily facilitate reforms in the hospital structure.
The report concluded, "Toyota has erred too much on the side of global centralization and needs to shift the balance somewhat toward greater local authority and control".
