Global MPH Program Director James Macinko is co-author of a new article in the journal Health Affairs.

The article, "The Health Effects of Decentralizing Primary Care in Brazil", proposes that a renewed focus on primary health care could lead to improved health outcomes in developing countries. Moving more control to local authorities, or decentralization, is one approach to expanding primary care’s reach. While proponents argue that it increases responsiveness to local needs and helps local resources reach those in need, critics counter that it might increase fragmentation and disparities and provide opportunities for local economic and political gains that do not improve population health. Dr. Macinko and his co-author explore questions surrounding decentralization using the example of infant mortality in Brazil, and their study finds positive effects on health outcomes in that context.

The article is available online here.