Decentralized health services and the children's right to health : a case study of Birere Sub-County, Isingiro District

Abstract

The purpose of the study was to establish whether decentralized health services (DHS) had satisfactorily· contributed to the realization of the right to health of the children in Birere sub-county. This was prompted by the fact that despite the DHS, the levels of children who were suffering and dying of preventable diseases were still high in this sub-county. The study was conducted as a cross sectional descriptive survey following four objectives: (I) Examine the human rights instruments related to the children's right to health; (2) Establish the performance of delivering DHS to children in Birere sub-county; (3) Establish the contribution of DHS to the realization of the children's right to health in Birere sub-county ;(4) Identify the challenges of DHS that inhibit the realization of the children's right to health in Birere sub-county; and (5) Recommend how the realization of the children's right to health can be improved under decentralization. Data were collected using documentation, interview and observation guides and questionnaires administered to the district and health officials, adults and children selected using purposive and snow ball sampling techniques. The data were analyzed both qualitatively and quantitatively with the aid of the SPSS computer programme. Results indicated that apart from such DHS as primary education, immunization and antenatal, the performance of delivering other services was not only minimal but also below expectation. Few mothers and children accessed the services. Therefore, despite the fact that the DHS were generally making a significant contribution to the realization of the children's right to health, the contribution was found to be unsatisfactory due to under-funding and other challenges that faced the DHS centres. Accordingly, the study concluded by rejecting its hypothesis, implying that the DHS had not satisfactorily improved the realization of the right to health of the children in the sub-county. It recommended improvement of the contribution of the DHS through increasing the funding and technical quality of DHS centres; sensitizing the community about DHS utilization; adoption of the human rights-based approach in health service delivery and engaging NGOs in strategic partnership. The study also recommended that more power be devolved to the sub-county so that the locals are empowered to promote the realisation of the children's right to health.