Decentralising urban health activities in developing countries: issues in planning

While there is considerable documented experience of decentralisation of health services in rural areas of developing countries, the decentralisation of health services in the urban context is rarely analysed. Urban development literature usually fails to address health issues, while the literature on decentralisation of health services tends to ignore the urban sector. This article addresses the relationship between a Ministry of Health and a City Council and identifies key issues to consider in the decentralisation of urban health activities: roles and responsibilities; legislation; co-ordination and communication; and resource constraints. The case study from Maseru, Lesotho highlights aspects of planning which need to be considered by national and local governments which are trying to strengthen urban health activities by decentralisation.