EFFECT OF DECENTRALIZATION POLICY ON HEALTH SERVICE DELIVERY IN NORTHERN DIVISION, MBALE CITY.
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2024-10-12
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Abstract
Improving health service delivery is one of the most serious challenges affecting people and their government and less attention have been given to the effect of decentralization policy in improving health service delivery. The purpose of the study was to examine the effect of decentralization policy on the delivery of health services in Northern Division of Mbale City. Specifically, the study assessed the effect of political decentralization and fiscal decentralization and health service delivery in Northern Division of Mbale City. It also established the effect of administrative decentralization and health service delivery in Northern Division of Mbale City. The study used cross sectional design to present data with the help of both qualitative and quantitative and qualitative techniques. Data was collected data from 80 (Eighty) participants in the study area using questionnaires and interviews guides and study participants were selected through simple random and purposive sampling. Quantitative data was analyzed using descriptive and inferential statistics (Mean and standard deviation) while qualitative data was analyzed thematically using illustrations and illustrations. Findings show that there exists citizen’s particular through democratic process there is always quality interaction between residents and local as this was indicated in the study finds and budget preparations are always participatory in nature citizens through their elected leaders have more powers in decision making and this was mentioned by participants in the study. Also it was found that there exists accountability within the division local government as found by the study local citizens are in position to hold local decision-makers accountable for their actions. Findings further revealed that the division council has authority over revenue collection and this was indicated in the study findings and there exist adequate fiscal transfers from the central government to the urban council also, the division council sets the tax bases from which it generates revenue and there exists a variety of tax bases from which the division council raises tax revenue and this was according to the study findings
It is true according to the findings that there exists a variety of tax bases from which the division council raises tax revenue. Further, findings show that it was revealed from the study findings, the division council enjoys corporate status and powers to secure its own resources to perform its functions and the division council has developed guidelines for community capacity building for effective participation and monitoring and this was indicated in the study. Other findings indicate that there exist established health committees with an appropriate gender balance to handle health related issues as revealed in study findings and also, the division council remains fully accountable to the central appointing office while performing its functions as well as employees are responsible and expected to give an account for outcomes for the portion of the work directly under their control. The researcher recommended increasing funding to decentralized units and building the capacity of leaders in these units to provide and monitor health service delivery infrastructures and services more effectively while at the same time encouraging citizen participation