An Impact Assessment of Decentralization on Health Care Service Delivery: The Case of Gozamin Woreda- amhara National Regional State
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Date
2014-06
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Addis Ababa University
Abstract
This study, Impact Assessment of Decentralization on Health Care Service Delivery was done at
Gozamin woreda of East Gojjam Zone Administration in Amhara National Regional state. The
major objective of the study was to assess the impacts of decentralization on the health care
service delivelY. The current status of health care services, the responsibilities and functions of
the woreda health office, the level of community participation and the major challenges of the
woreda that hinder from providing quality health care services were. reviewed.
Methodologically, a descriptive research design with qualitative research technique/ method was
employed to collect the data for the study. The instruments used to collect the data are
interviews, focus group discussions and field observations. Primary and secondary data were
collected from different Health institutions in the Woreda as well as fi-om annual offiCial health
sector reports and documents. The analysis part was supported by legal and official documents.
The findings of the study revealed the recruitment of health personnel, collection of user fee,
management and supervision of health institutions, in-service training and career development
of health workers are devolved to the woreda. The study also found that undertaking
construction of health HCs and health posts is given to the woreda in a delegated form. Whereas,
purchasing of drugs alld other pharmaceutical equipments are highly centralized, controlled by
the regional governments. The health care service accessibility and coverage of the woreda in
terms of expansion of health care institutions has shown all improvement, it reach 100%.
However, shortage of health personnel (midwifery, lab technician and pharmacy technician),
shortage of finance for duty service and per-diem payment, and drugs shortage are the
challenges of the woreda health care delivelY system that affects the quality of the services.
Moreover, according to the patients and }:ouseholds view, the costs of health care treatment is
high as compared to the ability of most beneficiaries incomes, the free service scheme-which is
very impressive were abused by kebele officials and weak one to five and one thirty network or
groups were also the challenges of Gozamin woreda health care service delivelY system.
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Keywords
Assessment of Decentralization on Health Ca r e Service