Role Of Decentralization In Improving Public Services: Evidence From Health Sector, Nono District

Abstract

The decentralization governance system is noteworthy in improving nearby public health service delivery as it transfers authority to serve from central to local government. The aim of the study was to assess the role of decentralization system in improving current year health service delivery in the case of Nono district health sector. The research was descriptive and mixed approaches. For attainment of objectives of the research, both primary and secondary data were obtained using different data collection instruments including survey questionnaires, KII and FGD. Moreover, purposive sampling was used to sample respondents of KII and FGD and stratified random sampling to identify participants of survey questionnaire respondents. Out of total 184 target total populations, 126 workers of health sector in the district were randomly selected and contacted for survey questionnaire based on stratified random sampling. The collected data was carefully processed and analyzed using SPSS v-20. Data collected using closed ended questionnaire were analyzed using quantitative method while data collected through open ended questionnaire, KII and FGD were analyzed using qualitative data analysis method. The result of the study indicates that decentralization governance system was not well implemented as needed. Despite its medium level implementation, it was found that decentralization has role to improve health service delivery in terms of providing local government health service issue decision making space, resource mobilization, health facility improvement, reaches level, health representatives’ empowerment level, enhancing local community participation and improving workers’ accountability and responsiveness level to serve in different magnitudes and dimensions. It was noted trough the study that although there was high level satisfaction with health service improvement progression level, effectiveness level of health service quality improvement was not well satisfy these community in the district. Nevertheless, health decentralization adaptation to improve health service in the district was subject to different factors especially with that of economic and political challenges as identified through the study. The researcher recommends local health governors, local community in the district, higher structures and stakeholders to properly implement decentralization system that further enhance health service in turn ensures emphasized local community beneficiary of improved health service to create healthy and satisfied community that can play role in sustainable development.