An assessment of the functioning of health sub-districts under decentralized health services in Mbale District

Abstract

This study was carried out in Mbale district to assess the functioning of the health sub Districts under the decentralized National health policy. The study was prompted by the fact that in spite of the creation of HSDs with good intentions of improving health service delivery, the report of the Mbale DDHS (Quarterly report, April 2005) to the LC V Council indicated that the communities in Mbale district remained dissatisfied over the delivery of health services. The study adopted a survey research design so as to cover a wider area of the district and collect views that are representative of the situation in Mbale district. With this research design, a questionnaire, interviews, focus group discussions and observation were used to collect data from heads of health units, and the DDHs at the district. In addition, focus group discussions with Health unit Management Committees and questionnaires to directly collect data from staff in the health units. The results of the study indicate that the quality of health services delivery of the HSDs is still poor, community participation is not adequate and the allocation of resources is still based on the MOH guidelines. There are several challenges such as poor support supervision, lack of adequate facilities, inadequate staffing and low attitude for the communities to come for health services in the Health centers within the HSDs. It is concluded, from the evidence in the study that the functioning of the Health sub Districts in Mbale district has not effectively advanced the MOH strategy to deliver the UNMHCP as part of furthering decentralization of health services under the National Health Policy to the populace. The study recommends among other things, the need for the office of the DDHS to disseminate information about the National Health Policy, sensitize and facilitate the HUMCs to effectively function in accordance with the UNMHCP guidelines of the decentralized National Health Policy.