Health Service Delivery of Local Government (A Study of Bardagoriya Rural Municipality, Kailali District)

Abstract

Effective health service delivery plays significant role in the prosperity and holistic development of Nepal. Nepal has made several significant efforts on health protection and promotion over the past several years. The Government Operation Act 2074 also play has been playing significant role in decentralization of health service delivery. This study entitled Health Service Delivery of Local Government: A Study of Bardagoria Rural Municipality, Kailali thus tried to examine status of health service delivery. Methodologically, this study applied quantitative and qualitative (Mixed) approach. Required data/information were collected by applying Survey, Key Informant Interview and Observation techniques in which survey questionnaire, observation checklist and Key Informant Interview guideline were used as tools of study. More specially, survey questionnaire were filled up by 135 client belonging to two health institutions: Dododhara Hospital and Kotatulsipur Health Post selected randomly. More specially, of the total 135 respondents, 81 respondents were selected from Dododhara hospital and 54 were selected from Kotatulsipur Health Post. The theoretical ideas such as devolution, service delivery and decentralization system have been applied while interpreting data. The results indicates that local government able to increased numbers of basic health institutions without complete facilities. Even emergency services are not available in the only hospital of Bardagoriya Rural Municipality. The study found that 45.2 percent of the client belong from 15-29 years age group and 61.5 percent were females. The education level among the client was 60 percent for both primary and secondary level. Below 12 percent respondents were good health condition, around 11 percent health people were visit health institutions for health related preventive services such as family planning, vaccination services. 57 percent of the client’s family occupation were agriculture. 55.6 percent client were satisfied the convenience of location of health institute. Both the hospital and the health post are very far from ward no. 3 and there is a lack of a bridge over the river, so it is difficult for the people to get regular vaccinations during the rainy season. Overall, this study concluded that decentralization can help improve the quality of health service delivery if local representatives have managerial skills and if there is good coordination between local government and health institutions.