Public Health Service Delivery in a Decentralized System: A Qualitative Study of the Perception of Health Providers and Community Members in Gida Ayana Woreda, Western Ethiopia

Tolera H; Tegegne Gebre-Egziabher; Helmut Kloos

Public Health Service Delivery in a Decentralized System: A Qualitative Study of the Perception of Health Providers and Community Members in Gida Ayana Woreda, Western Ethiopia

Tolera H * §

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Tegegne Gebre-Egziabher

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Helmut Kloos

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Addis Ababa University

Public Health Service Delivery in a Decentralized System: A Qualitative Study of the Perception of Health Providers and Community Members in Gida Ayana Woreda, Western Ethiopia

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Abstract

Some policy-makers believe a decentralized health system enhances service delivery by improving authority, autonomy, accountability, and community participation at the local level. Evidence on the extent to which these benefits have been realized and whether there are gaps in service delivery is essential for policy designs and system reinforcing strategies. The study gathered data through 29 interviews with service providers and policy-makers and eight FGDs with residents and analyzed it for themes. The results showed several benefits of the decentralization system program that includes increased autonomy over staff planning, budgeting, appointments; increased participation in service boards, in cash and kinds. The findings also revealed several challenges that hinder the effective functioning of decentralization including lack of authority to recruit staff, interference in the appointment, transfer of cases, procurement; limited decision making power over local revenue resources; lack of community responsibility in service planning and monitoring.

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Funding

No external funding was declared for this work.

Conflict of Interest

The authors declare no conflict of interest.

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Not applicable for this article.

How to Cite This Article

Tolera H, Tegegne Gebre-Egziabher, Helmut Kloos. 2019. "Public Health Service Delivery in a Decentralized System: A Qualitative Study of the Perception of Health Providers and Community Members in Gida Ayana Woreda, Western Ethiopia". Global Journal of Medical Research - K: Interdisciplinary GJMR-K Volume 19 (GJMR Volume 19 Issue K2).

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GJMR Volume 19 Issue K2

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Journal Specifications

Crossref Journal DOI 10.17406/gjmr

Print ISSN 0975-5888

e-ISSN 2249-4618

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GJMR-K Classification NLMC Code: W 84

Submission ReceivedDecember 13, 2018
Peer Review Double Blind
Handling Editor
Accepted January 5, 2019
Published January 15, 2019

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v1.2

Issue date

March 30, 2019

Language

English

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Article Matrices

Total Score: 113

Country: Ethiopia

Subject: Global Journal of Medical Research

Authors: Tolera H, Tegegne Gebre-Egziabher, Helmut Kloos (PhD/Dr. count: 0)

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