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Virginia Tech

Decentralization and Hospital Governance in Rural Paraguay

Abstract

dc:description.abstract

This study explores hospital board governance, particularly the dimensions of accountability, transparency and civic participation, within Local Health Councils (LHCs) in two locations in rural Paraguay. The democratization and decentralization efforts of the Paraguayan federal government in the last 20 years resulted in creation of the LHCs, but little research has been conducted on how these entities are now working in comparison to the expectations envisioned for them. This study examines LHC member understanding and practices by conducting semi-structured interviews with council members in two different locations. I reviewed relevant Paraguayan law and compared LHC member responses with the legal expectations of the role of the LHC and council member responsibilities. I also reviewed several health council organizational documents, such as rules and procedures, financial statements and by-laws, with the same intent. Using interpretive social science methods, I analyzed this data in conjunction with the information I gathered through participant-observation during my Peace Corps service in one of the communities examined here. This study finds that local health councils face numerous challenges to governance, including member role confusion, few implemented planning and oversight processes, weak systems of accountability and a lack of resources and support given to LHCs, creating a great challenge to meet expectations set out for them by federal law.

Degree

thesis:*
Name thesis:degree_name
Master of Urban and Regional Planning
Level thesis:degree_level
masters
Discipline thesis:degree_discipline
Urban Affairs and Planning
Department dc:contributor.department
Urban Affairs and Planning
Grantor dc:publisher
Virginia Tech
Year dc:date.issued
2012

Author and committee

dc:creator, dc:contributor.*
Author dc:creator
  • Erickson, Julie B.
Chair dc:contributor.committeechair
  • Stephenson, Max O. Jr.
Committee members dc:contributor.committeemember
  • Hall, Ralph P.
  • Stivachtis, Yannis A.

Subjects

dc:subject × 5

Rights

dc:rights
Statement dc:rights
  • In Copyright
Language dc:language.iso
en_US

Identifiers

dc:identifier.*
Dc Identifier Other
etd-05082012-225655
OAI identifier oai:identifier
oai:vtechworks.lib.vt.edu:10919/76995

Chain of custody

source
Harvested from
Virginia Tech
Base URL
vtechworks.lib.vt.edu/oai/request
Last updated
2026-07-22
Source record
OAI-PMH GetRecord
citation

Erickson, Julie B.. Decentralization and Hospital Governance in Rural Paraguay. masters thesis, Virginia Tech, 2012. http://hdl.handle.net/10919/76995