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were entering the political and legal systems and processes of decentralisation towards the most peripheral levels of administration were occurring in many countries, Italy included.
Localization is a framework for health services to be produced and provided locally, including at the most peripheral levels, drawing on local resources as much as possible.
In a suitable process of decentralization, there are changes at all levels of responsibility, reaching the smallest units and the most peripheral levels of decision making.
Thirdly, to complement the aforementioned standardized registers and formats, clearly defined standardized data processes and guidelines need to be designed for staff at the most peripheral levels of the health system.
Ideally, coverage monitoring should be based on accurate and timely reporting of administrative data that is reported up from the most peripheral levels to the national, regional and global levels.
Regarding medical expertise, heath systems will need to significantly expand "training of trainers" at the most peripheral levels to transmit clinical knowledge to CHWs and other local service providers.
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The foremost is effective delivery of services at the most peripheral level of healthcare services in the country.
The dispensary is the most peripheral level of service delivery, catering for between 6,000 to 10,000 people.
Few studies recruited patients at the first-contact point, the most peripheral level of the health service, ie health centres or health posts.
For example, the level designated as Health Centre I is the most peripheral level of health services, with no permanent facility but with community or village health workers offering mainly preventive services within their communities.
The geographical coverage of healthcare services, which has extended to the most peripheral level of district and sub-district, is reflected in Figure 2. The hospital bed-population ratio reduced from 1 1395 in 1960 to 1 450 in 2007.
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