Decentralization and Public health services delivery in Juba County, Central Equatorial State, South Sudan. A cross-sectional study.
DOI:
https://doi.org/10.51168/6483s712Keywords:
Decentralization, Public health service delivery, Juba County, South SudanAbstract
Background
Decentralization aims to improve efficiency, accountability, and access to essential health services through the transfer of decision-making authority from central to local governments. The study sought to determine the effects of decentralization on public health services delivery in Juba County, Central Equatorial State, South Sudan.
Methodology
A descriptive research design was employed, involving 150 respondents drawn from public health users, health students, staff, partners, and local authorities. Data were collected using structured questionnaires and analyzed through descriptive statistics, Pearson correlation, and regression analysis using SPSS Version 24.
Results
The majority (60%) were aged between 18 and 30 years, and 57% of respondents were female. Administrative decentralization had a moderate positive and significant correlation with public health service delivery (r = 0.506, p < 0.05), accounting for 31.3% of the variance (R² = 0.313). Fiscal decentralization showed a strong positive relationship (r = 0.690, p < 0.05), explaining 47.6% of the variation (R² = 0.476), while political decentralization demonstrated the strongest positive correlation (r = 0.711, p < 0.05) and explained 50.5% of the variance (R² = 0.505).
Conclusion
The study established that decentralization positively influences health service delivery when adequately supported by local capacity and fiscal accountability.
Recommendation
The government should strengthen local governance structures, increase funding for county health systems, enhance transparency, and promote participatory decision-making to achieve equitable and efficient public health services.
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Copyright (c) 2025 Kidi Samuel R. Kulang, Richard Semanda, Dr. Katerega Salongo (Author)
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