Localization of health systems in low- and middle-income countries in response to long-term increases in energy prices

Sarah L. Dalglish, Melissa N. Poulsen, Peter J. Winch

Research output: Contribution to journalArticle

Abstract

External challenges to health systems, such as those caused by global economic, social and environmental changes, have received little attention in recent debates on health systems' performance in low-and middle-income countries (LMICs). One such challenge in coming years will be increasing prices for petroleum-based products as production from conventional petroleum reserves peaks and demand steadily increases in rapidly-growing LMICs. Health systems are significant consumers of fossil fuels in the form of petroleum-based medical supplies; transportation of goods, personnel and patients; and fuel for lighting, heating, cooling and medical equipment. Long-term increases in petroleum prices in the global market will have potentially devastating effects on health sectors in LMICs who already struggle to deliver services to remote parts of their catchment areas. We propose the concept of "localization," originating in the environmental sustainability literature, as one element of response to these challenges. Localization assigns people at the local level a greater role in the production of goods and services, thereby decreasing reliance on fossil fuels and other external inputs. Effective localization will require changes to governance structures within the health sector in LMICs, empowering local communities to participate in their own health in ways that have remained elusive since this goal was first put forth in the Alma-Ata Declaration on Primary Health Care in 1978. Experiences with decentralization policies in the decades following Alma-Ata offer lessons on defining roles and responsibilities, building capacity at the local level, and designing appropriate policies to target inequities, all of which can guide health systems to adapt to a changing environmental and energy landscape.

Original languageEnglish (US)
Article number56
JournalGlobalization and health
Volume9
Issue number1
DOIs
StatePublished - Nov 7 2013

Keywords

  • Access to care
  • Climate change
  • Decentralization
  • Developing countries
  • Health systems reform
  • Localization
  • Rural health

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Fingerprint Dive into the research topics of 'Localization of health systems in low- and middle-income countries in response to long-term increases in energy prices'. Together they form a unique fingerprint.

  • Cite this