Assessing the effectiveness of decentralisation in health service delivery in Mpigi District the case of Buwama health centre iii in Buwama Sub County

Abstract

The study aimed at assessing the effectiveness of decentralization in health service delivery in Mpigi District a case of Buwama Health Centre III in Buwama Sub County. The study objectives were; To find out how the delegation of hospital administration has led to access to drugs in Buwama Sub County; To evaluate how fiscal decentralization has led to delivery of health services in Buwama Sub County and to assess how the devolution of authority on decision making has led to health facility utilization in Buwama Sub County. The study employed a case study design approach using qualitative research paradigm in which data was collected from 30 (thirty) respondents using questionnaires, and interviews The study found out that Even though decentralization has faced challenges in Buwama Sub County characterized by shortage of drugs and limited infrastructure, overall the researcher concludes that decentralization policy has had a number of positive effects in the delivery of health services in Mpigi District. This is based on the fact that health centers are beginning to be self-sustaining through fiscal decentralization, in that they can generate their own revenue for operations. Furthermore devolution and delegation have enabled important decisions to be made quicker such as purchase of health needs, recruitment of staff for the health centers and involvement of the local community in decision making. It was recommended that Fiscal decentralization should be enhanced in order to increase on the revenue generated at local government health facilities if sustainability is to be realized. It was also recommended that monitoring of health workers activities and attendance needs to be addressed. For instance by availing an attendance registers and punishing absenteeism. This will ensure the local population have better health care