International experience and health sector reform: the challenge for developing health systems

Health sector reform is a priority issue in many countries and there is great scope for an international exchange of experiences. We should not be amiss, however, to the problems and dangers of such international exchange. Focusing on the situation of developing countries, three critical problems are identified: tendencies to the universalism of a market approach, a one-way transmission of ideas, and the lack of policy analysis. In order to contribute to a more constructive process of international exchange, four recommendations are proposed in the areas of training and the approach to management, management research, strengthening health policy analysis, and developing new exchanges between countries.