Decentralization and Health Service Delivery in Lira Municipal Council

TABLE OF CONTENTS

DECLARATION

APPROVAL ii

DEDICATION iii

ACKNOWLEDGEMENTS iv

LIST OF ABBREVIATiONS v

LIST OF TABLES vi

TABLE OF CONTENTS

ABSTRACT X

CHAPTER ONE 1

INTRODUCTION

1 .0 Introduction I

1.1 Background of the study I

1 .2 Statement of the problem 3

1.3 Purpose of the study 4

1.4 Specific Objectives of the study 4

1 .5 Research Questions 4

1.6 Scope of the study 4

1.6.1 Subject scope 4

1 .6.2 Geographical Scope 5

1.6.3 Time scope 5

1.7 Significance of the study 5

1.8 Conceptual Framework 6

1.9 Operational definitions 7

CHAPTER TWO 8

LITREATURE REVIEW 8

2.0 Introduction 8

2.1 Effect of decentralization on personnel management 8

2.2 Effect of decentralization on Logistics in health service delivery 12

2.3 Effect of decentralization on operational environment 13

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2.4 Summary .16

CHAPTER THREE 17.

METHODOLOGY 17

3.0 Introduction 17

3. 1 Research design 17

3.3 Research Population 17

3.3.2 Sampling Procedure 18

3.3.3 Sample Size 18

3.4 Sources of data 19

3.4.1 Primary data 19

3.4.2 Secondary data 19

3.5 Data collection instrument 19

3.5.1 Questionnaire 19

3.6 Data Quality control 20

3.7 Research Procedure 20

3.8 Data Analysis 20

3.9 Ethical Considerations 20

CHAPTER FOUR 22

DATA PRESENTATION, INTERPRETATION AND ANALYSIS 22

4.0 Introduction 22

4.1 Demographic aspects of respondents 22

4.1.1 Sex of Respondents 22

4. 1 .2 Age distribution of respondents 23

4.1.3 Academic Qualifications of respondents 23

4.1.4 L~ngth of service in the municipality 24

4.2 Effe~t~of decentralization on personnel availability in health service delivery in Lira

municipality 25

4.3 Contribution of decentralization on stock availability in health service delivery in Lira

municipality 28

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4.4 Role of decentralization on the operational environment in health service delivery in Lira

municipality 30

CHAPTER FIVE 33

DISCUSSION, CONCLUSION AND RECOMMENDATIONS 33

OF THE FINDINGS Error! Bookmark not defined.

5.0 Introduction 33

5.lDiscussion of findings 33

5.2 ~onc1usion 36

5.4 Recommendations 36

5.5 Areas of further study 36

Appendix i: Questionnaire 38

ABSTRACT

The purpose of the study is to assess the contribution of decentralization towards health service delivery. The study objectives were to establish whether decentralization had led to Personnel availability in health service delivery, assess whether decentralization has led to stock availability in health service delivery in Lira municipality and determine the extent to which decentralization has led to and improved operational environment. The study was conducted from Lira municipality from the employees using the research questionnaires; the sample was 60 respondents who provided the data. The study adopted a descriptive research design; the analysis was done based on frequency and percentages. Overall it was realized that decentralization ensures effective health staff recruitment had 80% of the respondents who strongly agreed and agreed. Overall the findings indicate that most (55%)of the respondents were in support that that there are reasonable contributions brought when the stock is decentralized in health service delivery in Lira municipality decentralization Overall, most respondents (60%) of respondents agree that the operations environment has enables the municipality to have sufficient equipment availability from central government The study was set to establish the effect of decentralization on health service delivery in Lira Municipality, Lira district, northern Uganda. It should be noted that decentralization ensures effective health staff recruitment; the municipality effectively appraises the performance of the health staff. Due to decentralization there is direct remunerations provided to health staff by the municipality, the study concludes that avenues for personnel management effectiveness need to be comprehensibly addressed in the decentralized management and environment. On the third objective the study conclude that decentralization had a low effect on operational environment in health service delivery in Lira Municipality The study recommends that there is need for improving the prevalence of decentralized administration improvement and enhancement for the purpose of improving the status of the personnel management. There is need for improving access to the stock of health supplies through improving provisions and management of the stock and the need for improvement of the state of affairs require employing more supervision mechanisms intended to generate workforce improvement.