Kuwait : Complete Profile - What is GIS - World Health Organization

Health Systems Profile- Kuwait Regional Health Systems Observatory- EMRO
no mechanisms for monitoring and supervision and enforcement of measures in the
event of non-compliance.
The health areas have well developed organizational structures with departments of
administration & finance, planning & information, legal research and engineering affairs
with laid out operational policies and procedures. Directors and managers are highly
qualified and experienced. However, there seems to be a limited capacity in health
system management. Coordination with central departments is weak and health
information system needs strengthening to support the decentralization process. There is
also a lack of clarity among regions as well as central departments about the rules and
regulations regarding decentralization and the extent of financial and administrative
authority.
Generally there are concerns among regions that overall health system is still highly
centralized; resources allocated to the regions are not enough and not based on their
needs; there is duplication of work and limited coordination between MOH and regions;
administrative and especially financial regulations are too restrictive; staff is appointed in
the regions without their consent or consultation; and they do not have enough
authority to efficiently mange the affairs of the regions.
The current level of transfer of authority and responsibility in the decentralized system
can be explained on the basis of the decision space model,1 which gives the range and
extent of independence in decision making allowed by the Central MOH to the health
regions. Table 1 provides a quick mapping of the current decision space available to the
Health regions in Kuwait.
Table1. Level of Decentralization:
Health system functions Level of Government
Finance Central Regional
Revenue generation ++ +
Budgeting, resource allocation ++ ++
Power of expenditure +++ +
Line item flexibility +++ -
Income from fee and contracts +++ -
Information and Planning
Prepare annual plans +++ ++
Health information systems design +++ -
Data collection, processing, and analysis +++ +
Dissemination of information to stakeholders +++ +
Service organization
Hospital autonomy - -
Managing insurance schemes +++ -
Defining service packages +++ -
Setting norms, standards, regulations +++ -
Monitoring, oversight of service providers + ++
Contracts with private providers +++ ++
Human resources
Recruit staff +++ +
Dismiss staff ++ -
Reward staff ++ ++
1 Bossert T. (1998) Analyzing the Decentralization of Decision Space in Developing Countries:
Decision Space, Innovation and Performance. Soc Sci Med; 47(10):1513-27.
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