An assessment of the efficacy of decentralisation on public health service delivery: A case study of the Omaheke region
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Date
2025
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Publisher
University of Namibia
Abstract
This study assesses the impact of decentralisation on healthcare service delivery in the
Omaheke Region, Namibia. The study employed a qualitative approach, incorporating
data from a targeted sample of 30 participants out of a population of 406. Data
collection was conducted through semi-structured interviews, which allowed
participants to share their experiences and perceptions regarding the accessibility,
resource challenges, and engagement within the decentralised healthcare framework.
The findings indicate that decentralisation has made healthcare services more
accessible, especially in rural areas, due to the introduction of community health
workers and outreach programs. Participants noted that healthcare services are now
more reachable, which has reduced travel times for many residents and increased
engagement in preventive care. However, resource inconsistencies, particularly
medication shortages and insufficient staffing, emerged as significant challenges,
affecting the quality and reliability of services in the decentralised system. These
resource issues were commonly reported, underscoring the need for more consistent
supply chains and improved staffing levels to ensure effective healthcare delivery.
The study further found that decentralisation has empowered communities by
fostering greater engagement and local involvement in healthcare processes,
enhancing accountability and making services more responsive to local needs. Based
on these findings, the study recommends strengthening supply chains for essential
medical resources to mitigate shortages and implementing staffing improvements to
address service gaps. Additionally, investing in healthcare infrastructure by building
more clinics in underserved areas is advised to improve accessibility
Description
A thesis submitted in partial fulfilment of the requirements for the Degree of Master in Public Administration
Keywords
Healthcare services, Accessible, Responsive, Medication, Shortage, Namibia, University of Namibia