Decentralisation

The Ministry of Health re-asserts its total commitment to the decentralization policy. The health services will be administered, as at present, through the ten health regional directorates set up by the Ministry. The decentralization process will be pursued further and stabilized till its benefits are fully realized. MoH visualizes a scenario in which all regional directorates of health services plan, implement, monitor and evaluate their own health services / programmes within a policy and planning framework of the Ministry.

The role of the national head quarters of the Ministry will continue to be in a state of transition just as the regional head quarters take increasing responsibility for managing the health services under the decentralized set-up. As this evolution continues, the roles of national and regional headquarters will be re-defined from time to time, and greater responsibility and authority will be vested at the regional level.

The national head quarters will continue to shoulder prime responsibilities for policy making, strategic decision making, national health planning, programme designing, monitoring and evaluation. Every HQ Directorate General (HQ/DG) is responsible for developing appropriate policy guidelines, operating procedures or manuals etc. to be used by the regional directorate generals and institutions in a region.

The role of the Directorate General of Health Affairs (DGHA) exemplifies the pattern to be adopted by all other HQ / DGs. DGHA spearheads the development of specific health programmes (included in the health development plan) through its various directorates, and supports its implementation by the regional DGs. For this purpose DGHA develops programme manuals and implementation protocols, which are then distributed to the regional directorate generals. It trains the concerned regional staff in the use of the manuals and implementation of specific programmes. DGHA provides technical support to the regional directorates to resolve any difficulties in programme implementation encountered by them. Further, DGHA also independently monitors the programme implementation process and immediate outcomes of certain key programmes.

The HQ/ DGs will play a decreasing role in programme implementation and direct programme monitoring in the future, as the regional directorates develop increasing experience and competence in programme management. In the long run, the HQ /DGs including DGHA will be concerned mainly with programme development and independent evaluation. The HQ / DGs are expected to provide necessary technical / administrative support to the regional directorates. They will also seek greater involvement of the regional DGs in their respective areas such as health planning, human resources planning, financial planning, material requirement planning, recruitment, training, Omanization, etc. etc. The regional DGs, on their part, should extend their whole-hearted cooperation to HQ/DGs in their endeavours.

The regional Directorates are expected to support programme management in all its peripheral institutions through proper interpretation of national policies, guidelines, plans, manuals and other operating procedures. They are expected to undertake routine monitoring of all programmes and services throughout the region, and to take timely corrective action in order to ensure optimum results. The regional DGs are expected to provide timely feedback to the relevant HQ/ DG, should any action be necessary at that level to prevent un-intended outcomes, and to ensure optimum results. Relevant positive and negative feedback should also be given to the Wilayat Health Superintendent’s office and the concerned peripheral institutions. As this process continues, decentralization to the wilayat level will become a reality and the regional directorate will play decreasing role in programme management and increasing role in programme development and independent monitoring of health services and programmes.