Health and Decentralization: The Case of Gozamin District, Amhara State, Ethiopia

Abstract

Decentralization is assumed to be an important tool for a quality health care service delivery.  The objective of the study was to assess the impacts of decentralization on the health care service delivery Gozamin District, Amhara State, Ethiopia. Primary data for this study were collected through questionnaire, interview, and focus group discussions. Whereas secondary data were collected from annual official health sector reports and documents. The analysis part was supported by legal and official documents. The findings of the study revealed that the  health care service accessibility and coverage of the District in terms of expansion of health care institutions has shown an improvement, and it reaches 100 percent. However, shortage of health personnel (midwifery, lab technician and pharmacy technician), shortage of finance for duty service and perdiem payment, and drugs shortage are the challenges of the District health care delivery system that affects the quality of the services. 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 are the  challenges of Gozamin District health care service delivery system.

Keywords: Decentralization, Health Care Service Delivery, health center, and health posts