tralization of the currently mainly centralize hospital management system in Yemen, but also an effort for managed development. Of course, the new approach also includes an effort to create more sources of funding and higher levels of budgeting from already present sources. One of the biggest changes being instituted in Yemen is an effort to make hospitals autonomous in order to make them more efficient, even though they will still be integrated into the general Yemen health care system. Autonomous public hospitals are already successful in many parts of the world, most notably Britain and the US, and they are a model of management that delivers the greatest level of health care for the money expended, “An autonomous public hospital means a hospital with its own Board of Trustees. It has a highly skilled management team which manages the budget and hires and fires its own staff. It received its income by entering into service agreements with the Ministry of Health by which it receives a lump sum for an agreed package of services. It remains a public body which is accountable to the Minister of Health,” (Draft Paper 1).
The delivery of primary health care is one of the biggest obstacles facing Yemeni health care officials, and for this reason the new autonomously managed hospitals are being experimented with in two district and one governorate hospital. The governorate hospital is being chosen because at the present time they eat up more funding in proportion to primary care facilities and the Ministry of Health is attempting to see how the autonomous model will work with tertiary facilities. The heavily centralized health care system in Yemen has proven, as it has in most Middle East and developing countries, to be a failure. By utilizing the autonomously managed model of hospital organization the funding and delivery of hospital services is separated so that the government still retains funding and allocation authori...