An assessment on Decentralized Service Delivery in the Health Sector: The case of Ahferom Wereda

Abstract

This study attempted to investigate the An assessment on Decentralized Service Delivery in the
\nHealth Sector in Ahferom Wereda which is one of the administrative divisions of Tigray National
\nRegional State. The main objectives of this study was to examine adequate human resources and
\nhealth service availabilities including pharmaceutical commodities, the local level health
\nservice delivery arrangements in terms of accountability, the institutional capacity of local
\ngovernment in implementing and coordinating decentralized health service programs and
\npolicies and identify the challenges of decentralized governance in the process of health service
\nprovision. The study used a descriptive survey research design and employed both qualitative
\nand quantitative data types, specifically semi -questionnaires, semi-structured interviews and
\nfocus group discussion. In addition to this, study was employed both primarily and secondary
\nsources of data. The sampling designs used in this study are both probability and non probability
\nsampling designs. These are, purposive, clustered, lottery method, proportionate sampling and
\nfinally convenience sampling was employed. For the purpose of this, the study used a sample of
\n190 house hold heads. In addition to this, the study used 20 key respondents purposely. The key
\nrespondents with regard to this objective were officials in health related management and health
\nservice providers of the wereda .The major findings of this study reveals that though
\ndecentralization is contributing better health services availability, it constrains ensuring of
\nadequate human recourse, geographical accessibility and adequate pharmaceutical commodities
\nfor better health service delivery to the public. Besides, there is failure of accountability in
\nrelation to financial planning, reporting and implementation of activities, the availability of
\nchanneling procedures for complaints, strong institutional capacity in terms of leadership,
\nhuman resources management and financial management capacity. In relation to the challenges
\nin health service delivery; shortage of sufficient and competence human racecourses, inadequate
\npharmaceutical commodities, insufficient financial resources and weak leadership are identified
\nas the major challenges. The study recommended organizing public to participate in financing
\nand health service delivery, enhancing leadership and improvement, filling vacancies and
\nenhancing competency of the staff, strengthening standardized auditing instrument and
\nimproving and strengthening inter-organizational relations with different NGOs are more
\nrelevant.