Yes. The idea of decentralization is that you want to ensure that communities are empowered to take decisions on health care and to direct health care resources towards the issues that are most important within their community. This is a really important principle, and it's one that has been implemented well in places such as Canada, Europe, and to a significant extent in the health reform process in central and eastern Europe.
In Mozambique, for example, there is a decentralization of resources and a deconcentration of authority, but what happens is that at the local level there isn't the capacity to really analyze health information, and there might be more intransigent norms regarding the rights of women and girls. It's like social media, in a sense; it's a double-edged sword.
The idea of decentralization and deconcentration of authority to the local level is a really important one, but it's a question of how it's implemented. Ensuring that women and girls and their access to health care services are protected during that process is really quite critical, as is ensuring that local authorities have the capacity to make decisions.
I'm just finishing a paper that includes Sierra Leone and the Ebola crisis as a case study. One of the interesting comments about Sierre Leone during the Ebola crisis is that there had been a decentralization undertaken in the health system. What happened was that local health authorities did not feel empowered to act quickly on information they were receiving at the local level about Ebola. They were waiting for the central ministry. It shows that it's a good idea in practice, but the implementation can be quite tricky.