political reform designed to promote local autonomy, decentralization entails changes in authority and financial responsibility for health services. Hence, decentralization can have a large impact on health service performance. There are several forms of decentralization affecting the health sector in different ways: (i) deconcentration, which transfers authority and responsibility from the central level of the Ministry of Health to its field offices; (ii) delegation, which transfers authority and responsibility from the central level of the Ministry of Health to organizations not directly under its control; (iii) devolution, which transfers authority and responsibility from the central level of the Ministry of Health to lower level autonomous units of government; (iv) privatization, which involves the transfer of ownership and government functions from public to private bodies, which may consist of voluntary organizations and for‐profit and not‐for‐profit private organizations, with varying degree of government regulation