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The next stage of the reform agenda required responsiveness to local needs, accountability and innovation, none of which were possible without a revival of localism.
Our review yielded 30 studies, highlighting four key governance mechanisms by which governance may influence health outcomes in these settings: Health system decentralization that enables responsiveness to local needs and values; health policymaking that aligns and empowers diverse stakeholders; enhanced community engagement; and strengthened social capital.
This article assesses the key advantages and dilemmas associated with devolution such as responsiveness to local needs, downward accountability and health worker retention.
Firstly, we asked how decentralisation has affected the responsiveness to local needs and the accountability systems in relation to the recruitment of health workers.
Broadly, the regionalization of health service delivery in Canada has involved devolving decision-making power to intra-provincial regions and communities and away from provincial jurisdictions with the goal of improving responsiveness to local needs and circumstances.
Variations in team practice may reflect appropriate responsiveness to local needs, but may also indicate uncertainty or a lack of evidence regarding the most effective ways to conduct MDT meetings.
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43 This could have contributed to variability in outcomes between clusters, though we believe responsiveness to local need probably had the opposite effect.
Responsiveness to local need, and the flexibility to respond to this, is inherent in the CLAHRC model and many examples of flexibility have been described elsewhere [ 6, 8, 35].
SP programs need to be responsive to local needs.
The principles of preserving patient choice, responsiveness to local population needs, and patient-centred care reinforce the above direction.
[ 20] The Ministry of Health and Long Term Care's (MOHLTC) vision is that the LHINs will help improve patient-centredness, responsiveness to local health needs, and "local capacity to plan, coordinate, integrate, and fund the delivery of health services at the community level".
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responsiveness to local communities
responsiveness to individual needs
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responsiveness to community needs
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