An Impact Assessment of Decentralization on Health Care Service Delivery: The Case of Gozamin Woreda - Amhara National Regional State

Agegnehu, Alene (2014) An Impact Assessment of Decentralization on Health Care Service Delivery: The Case of Gozamin Woreda - Amhara National Regional State. Masters thesis, Addis Ababa University.

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Abstract

This study, Impact Assessment of Decentralization on Health Care Service Delivery was done at Gozamin woreda of East Gojjam Zone Administration in Amhara National Regional state. The major objective of the study was to assess the impacts of decentralization on the health care service delivery. The current status of health care services, the responsibilities and functions of the woreda health office, the level of community participation and the major challenges of the woreda that hinder from providing quality health care services were reviewed. Methodologically, a descriptive research design with qualitative research technique/ method was employed to collect the data for the study. The instruments used to collect the data are interviews, focus group discussions and field observations. Primary and secondary data were collected from different Health institutions in the Woreda as well as from annual official health sector reports and documents. The analysis part was supported by legal and official documents. The findings of the study revealed the recruitment of health personnel, collection of user fee, management and supervision of health institutions, in-service training and career development of health workers are devolved to the woreda. The study also found that undertaking construction of health HCs and health posts is given to the woreda in a delegated form. Whereas, purchasing of drugs and other pharmaceutical equipments are highly centralized, controlled by the regional governments. The health care service accessibility and coverage of the woreda in terms of expansion of health care institutions has shown an improvement, it reach 100%. However, shortage of health personnel (midwifery, lab technician and pharmacy technician), shortage of finance for duty service and per-diem payment, and drugs shortage are the challenges of the woreda health care delivery system that affects the quality of the services. Moreover, according to the patients and households view, the costs of health care treatment is high as compared to the ability of most beneficiaries incomes, the free service scheme-which is very impressive were abused by kebele officials and weak one to five and one thirty network or groups were also the challenges of Gozamin woreda health care service delivery system.

Item Type: Thesis (Masters)
Subjects: J Political Science > JS Local government Municipal government
K Law > K Law (General)
R Medicine > RZ Other systems of medicine
Divisions: Africana
Depositing User: Tim Khabala
Date Deposited: 24 May 2018 14:15
Last Modified: 24 May 2018 14:15
URI: http://thesisbank.jhia.ac.ke/id/eprint/4056

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