fbpx

Journal Article

IDS Bulletin 38.1

Decentralisation and Difference: Indigenous Peoples and Health System Reform in the Brazilian Amazon

Published on 1 January 2007

The implications of decentralisation for minority and marginalised groups are complex and contested. It has long been an article of faith for ‘decentralisation and participation’ advocates that bringing decision making closer to the grassroots is a prerequisite for overcoming the unresponsiveness of monolithic, top-down state service delivery systems or unaccountable, exclusionary privatised ones (Tendler 1997).

Other observers, however, have drawn attention to the difficulty of ensuring that decentralisation actually contributes to the democratisation of the ‘authoritarian enclaves’ (Fox 1994), where minority groups – and particularly indigenous peoples – tend to be concentrated. They have also noted that in general the process will tend to leave more power in the hands of local élites who are often implicated in maintaining and exploiting these groups’ political and economic marginalisation (Manor 1999).

Related Content

IDS Bulletin 38.1

Cite this publication

Shankland, A. and Athias, R. (2007) Decentralisation and Difference: Indigenous Peoples and Health System Reform in the Brazilian Amazon. IDS Bulletin 38(1): 77-88

Citation copied

Authors

Image of Alex Shankland
Alex Shankland

Research Fellow

Renato Athias

Publication details

published by
IDS
authors
Shankland, A. and Athias, R.
journal
IDS Bulletin, volume 38, issue 1
doi
10.1111/j.1759-5436.2007.tb00339.x
language
English

Share

About this publication

Region
Brazil

Related content