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