INTEGRATING NATIONAL AND DISTRICT HEALTH-PLANNING IN A DECENTRALIZED SETTING

Decentralization has received prominence in the international health l iterature as a desirable organizational reform. Much of the focus has been on the idealized benefits of decentralization, rather than on the practical considerations of how to implement the reforms. One practic al issue arising is the role of the national and peripheral levels in policy formulation, planning and implementation, and how, in the absen ce of formal controls, national policies and plans can be applied. Thi s paper describes the process adopted in Papua New Guinea to integrate national and district health planning in a decentralized setting. The key elements of the process were participation, learning by doing and integration. Aspects of the experience of international interest are highlighted.