Assessing the capacity of district hospitals in mobilizing and allocating resources after health care decentralization
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Date
2020-09-16
Authors
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Kamuzu University of Health Sciences
Abstract
qualitative cross sectional study aimed at assessing whether district hospitals have the
capacity to mobilize and allocate resources in light of decentralization, in Kasungu and
Nkhotakota District Hospital(s). Key informant interviews will be conducted using a
flexible interview guide.
b. The problem
It is common knowledge that the delivery of efficient health services requires adequate and
consistent availability of the right resources, be it human, financial, equipment or material
resources. This is the more reason Malawi is a signatory to the Abuja declaration where it
pledged to allocate 15% of the national budget towards the health sector. Over the years
the Ministry of Health, has put in place various strategies to aid in resource mobilization
for the health sector as a means to the Abuja declaration and one of such strategies is
decentralization of the health care system. However, despite the positive gains that have
been attributed to decentralization and health delivery systems, there still remains a gap in
addressing the limits of decentralization vis a vie authority accorded district health
management teams in health financing. In realizing this gap, this paper will look at how
decentralization has capacitated District hospitals in mobilizing and allocating resources.
This will assist the Ministry of Health through the Local Governments to address gaps in
resources usually associated with less than adequate service delivery in district health
facilities.
c. The Objectives
The specific objectives of the study are:
i.To explore the capacity of the hospitals in revenue generation and availability of essential
medicines and supplies.
ii. To explore perceptions on hospitals human resources management regarding
recruitment and retention measures.
iii. To explore perceptions of health personnel on their autonomy in light of
decentralization at district hospital.
16-Sep-2020.
The study will employ a qualitative approach which will enable us to have in-depth
understanding of the capacities of district health management teams in mobilizing and
allocating resources within their districts. To have rich data on the perceptions of managers,
key informant interviews will be conducted. Purposive sampling will be used to recruit 16
participants ranging from district health office managers, planning, administrative and
finance managers from the district assembly as well as 3-4 policy makers at Ministry of
Local government, Min of Health and Min of Finance/Treasury.
e. Expected Findings and Dissemination
It is anticipated that the study will generate findings that are well enriched with adequate
data that provides a deep understanding of the subject and contribute meaningfully to the
body of knowledge in health financing. We expect to determine whether capacitating
district health managers with authority would result in more opportunities arising,
improvements in resources such as essential medicine, equipment and supplies, noticeable
changes in revenue generation, and human resource attrition trends due to decentralization.
Final research data will be made available to other interested investigators, and
stakeholders. It is the intention of the investigator to submit findings to peer-reviewed
journals, present at national and international forums, and hold dissemination meetings
amongst important stakeholders including the Ministry of Health, through the District
Health Office and the Ministry Local Government through the District Councils.