• Syed Mohamed Aljunid Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia


Health sector reform is an ongoing political process involving most countries whether they are developed or developing economies. However, the reform process is unique in most countries and there is no specific blueprint that developing countries could follow. Initiatives that were found to work extremely well in one country may be found to produce disastrous results in other countries. Policy makers should draw experience from both developed and developing countries and from within or outside health sector. These experiences need to be modified to suit each country. It is important to develop methods to analyse effects of different policies on every angle of the society. Major stakeholders such as providers both in public and private sectors, community leaders, political leaders, consumers and workers should not be left out at every step in policy formulation and implementation. Bureaucracies in government administration should be reduced to ensure channels for communications with stakeholders are always open. In the long run, it is likely that developing countries need to find their own versions of health sector reform initiatives, very much different from those experienced in developed countries.


1. Aljunid SM, Zwi AB. Difference in public and private health care services in a rural district of Malaysia. The Medical Journal of Malaysia. 1996;51(4):426-35.
2. Aikin JS, Griffin CC, Guilkey DK, Popkin BM. The demand for adult outpatient services in the Bicol region of the Philippines. Social Science and Medicine. 1986;22(3):321-8 .
3. Belmartino S. The role of the state in health system. Social Science and Medicine. 1994; 39(9): 1315-1321
4. Bossert TJ, Beauvias J. Decentralisation of health system in Ghana, Zambia, Uganda and The Philippines: a comparative analysis of decision space. Health Policy and Planning 2002;17( I):14-31
5. Carr-Hill RA. Efficiency and equity implications of the health care reforms. Social Science and Medicine. 1994;39(9):1189-1201.
6. Cassels A. Health sector reform: key issues in less developed countries. Journal of International Development. 1995;7(3):329-347 .
7. Dutton D. Financial, organizational and professional factors affecting health care utilizations. Social Science and Medicine 1986;23(7): 721-35.
8. Enthoven AC. Modernising NHS. A promising start but fundamental reform is needed. British Medical Journal 2000;320: 1329-1331.
9. Habib OS, Vaughan JP. The determinants of health services utilization in Southern Iraq: a household interview survey. International JoJrnal of Epidemiology 1986;15(3): 395-403.
10. Haynes RM, Bentham CG. The effects of accessibility on general practitioners consultations, outpatient attendances and in­ patient admissions in Norfolk, England. Social Science and Medicine 1982;16: 561-69.
11. Heller P. A model of the demand for medical and health services in Peninsular Malaysia . Social Science and Medicine 1982;16(3): 267- 284.
12. Hongoro C, Chandiwana SK. The effects of the enforcement of user fees on the health care delivery system in Zimbabwe. Report of a study financed by Unicef, Ministry of Health and Child Welfare, Zimbabwe, Harare 1994.
13. McPake B, Hongoro C. Contracting out of clinical services in Zimbabwe. Social Science and Medicine. 1995;41: 13-24.
14. Mogedal S, Steen SH. Health sector reform and organisational issues at the local level: lessons learned from selected African countries. Journal of International Development. 1995;7(3): 349-367 .
15. Moses S, Manji F, Bradley JE, Nagelkerke NJD, Malisa MA, Plummer FA. Impact of user fees on attendance at a referral centre for sexually transmitted diseases in Kenya. The Lancet 1992; 340: 463-466.
16. Robinson R, Grand Le J. (eds) Evaluating the NHS reforms. Kings Fund Institute, London 1994
17. The World Bank. World Development Report. Financing Health Services in Developing Countries: An agenda for Reform. The World Bank, Washington DC. 1987.
18. The World Bank. World Development Report. Investing in Health. The World Bank, Washington DC. 1993
19. Walt G, Gilson L. Reforming the health sector in developing countries: the central role of policy analysis. Health Policy and Planning 1994; 9(4): 353-370.
How to Cite
Syed Mohamed Aljunid. (2002). HEALTHCARE REFORM: ITS RELEVANCE IN DEVELOPING COUNTRIES. Malaysian Journal of Public Health Medicine, 2(1), 1-5. Retrieved from