ABSTRACT

I. Introduction "Health sector reform is a sustained process of fundamental change in policy and institutional arrangements, guided by government, designed to improve the functioning and performance of the health sector, and ultimately the health status of the populations," (1). Health sector reform is occurring throughout the world in developed and developing countries alike. Major changes in the organization and financing of health services are already happening, which will have a significant impact upon the way in which tuberculosis (TB) control is organized. Health sector reform is not a single entity, and the content of reforms, the motivation behind them, and the process of implementation vary greatly between countries. Despite this, certain themes can be identified in most health systems that are undergoing reform (2), although the extent to which they are actually being implemented in any system will vary (Table 1).