Community Tolerance Reconciliation and Development`s Action for Accountability Groups implemented a social accountability monitoring exercise and conducted social audit the found out that the health delivery system was in deplorable state. The hospitals and satellite clinics suffer major shortage of doctors and nurses, CD4 Count, viral load, cervical cancer and x-rays machines. Health delivery systems in Zaka district are in intensive care a development that thwarts the realization of health for all which is enshrined in the constitution.
The public health is riddled with shortages of drugs water and sanitation services. Thousands of villagers still have to travel for long distances to seek health care services at Hospital which is in ward 3 Zaka North Constituency the hospital is overburdened by the huge number of patients from Zaka Central, East and West constituencies. Several wards lack clinics and few facilities established are poor and have limited accommodation for the staff. The rural district council is failing to expand infrastructures inherited from the colonial masters resulting in overburdening of the district central hospitals.
COTRAD believes that one of the ways of making health care more accessible is to decentralize the bureaucracy down to the regions, rural areas and neighborhoods, based on the assumption that a decentralized health care delivery system is more responsive to local needs. The professional staffs working at a decentralized level are more likely to be perceptive of the norms and needs of the local residents. Decentralization is not just concerned with the equalization of resources, but also with responsibilities and facilities controlled at a local level.
Within the health field, facilities such, as land, buildings, and manpower to build health centres can be utilized. In decentralizing health services increased use is made of paramedical personnel, who are produced in greater numbers. These paramedical can be recruited locally and are not likely to have language or cultural barriers to the delivery of services to the masses. A decentralized health system makes preventive work much more effective. If the locally recruited staffs are elected by their communities to be trained, they are likely to be more accountable to the masses than to the bureaucracy. In a democratically decentralized system, the consumers are more likely to participate in decision making and in controlling their own health resources.
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