Sharing Best Practices in Strengthening Local or District Health Systems

Abstract

Meeting the basic health needs of the people requires that governments define policies and ensure their successful implementation at local or district level. A “health district” means a clearly defined administrative area covering a population at whose level some form of local government or administration takes over many responsibilities from central government departments.1 2. The concept of District Health Systems (DHS) has been widely promoted by WHO2 in the firm conviction that the district is the most important level for improving efficiency and responding to local health priorities and needs with focus on high-impact health interventions. The district is in the best position to address local challenges through seizing local opportunities and responding to people’s health needs. 3. Experiences with decentralization in countries in the African Region have shown mixed results. In some countries, decentralization has been accompanied by effective transfer of authority and responsibility from the central level to the local/district level while in others weaknesses in institutional capabilities coupled with instability in policy and environment have undermined the performance of DHS.