Decentralization as an effective means of promoting the right to health: a case study of Kabale Municipality, Kabale District.

Abstract

The study set out to examine decentralization as an effective means of promoting the right to health. The study was guided by a number of objectives which include: examining the issues concerning community accessibility to health services, assess the level/ extent of health education to the community members, challenges affecting the promotion of health services to the communities and to evaluate the opportunities of the community members in the promotion of good health.

The study was undertaken in Kabale municipality, Kabale district. The study was carried out using a self-administered questionnaire to the health service users in Kabale municipality and an interview guide that was administered on an individual basis to the health staff in the municipality. The results were analysed both qualitatively and quantitatively in order to reach to appropriate conclusions and recommendations.

The major findings of the study included the fact that; From the study, it is clear that much as the local government health centers were close to the people (with in 0-5 km from the majority of the respondents), they were among the least preferred sources for health care services. It was hence found that besides distance, there were other issues/factors considered by respondents in selecting a source of health care services. The study found out that the treatment; numbers of medical personnel, drugs and equipment in local government health centers were inadequate. Almost all respondents (over 90% for both males and females) described the speed of service delivery in local government health centers as either being very slow or just inadequate.

The services in government health centers were of poor quality. This perceived poor quality of services offered at local government health centers rather than the distance might explain respondents’ least preference of such health centers. It might therefore require that health sector development efforts focus on service quality improvement besides increasing accessibility through increasing the number and spread of the health centers.

The study found out that the ethical considerations in service delivery has continuously been mixed up with politics. There is neglect of the poor members of Society where the Government departments operate without policies to help the poor access the services.

From the study, it was concluded that health education and promotion programme aims at promoting individual and community responsibility for better community health and sanitation. It is observed that implementation is very weak and that while the level of awareness is high there is no corresponding change in behaviour.