local health funds and local government health promotion projects.
With the increasing involvement of municipalities and subdistrict administrative
organizations, together with NHSO branch offi ces and PHOs, there is an expanding
administrative infrastructure at regional and provincial levels. However, the mixed
arrangements that are emerging risk excessive system complexity and even a
degree of organizational fragmentation, so future policies need to be informed
by research evidence regarding the organizational framework required to deliver
universal health coverage at the local level (see Box 6 below).