EXPLORING REALITIES OF LOCAL GOVERNMENT HEALTH SERVICE DELIVERY: AN EMPIRICAL EVIDENCE FROM BALANGODA URBAN COUNCIL

Abstract

In Sri Lanka, LG has faced numbers problems and challenges while delivering needy health services in its locality. As such, Balangoda Urban Council (BUC) has been selected as the case study in order to explore the realities of local government health service delivery in Sri Lanka, to analyse the different problems and challenges which affect the better health service delivery in BUC, to identify the innovations and strategies being planned and implemented by the BUC in order to improve the health service delivery and to assess the success or appropriateness of these innovations and strategies. The study was based on both qualitative and quantitative research methods. The Qualitative and quantitative data were gathered by using primary and secondary sources. To analyse quantitative data statistical method was used with SPSS. The discourse analysis and narrative analysis were used to analyse the qualitative data, and they were presented using texts, narratives, tables, chats and figures. The study found that BUC failed to ensure the better health service delivery to the public. The main factor for that it doesn’t has an appropriate constitutional and legal framework, institutional capacity, service delivery mechanism built up by public-private partnership and mutual understand between national and local political leadership. This situation leaded to emerge the various challenges in health service delivery include shortage of sufficient and competence human racecourses, disputable politics, unclear powers and functions to undertake the health service delivery, poor public-private partnership, inadequate financial resources, inadequate physical resources, inaccessibility to community for health services, and poor public participation. For the sustainability of health service delivery, the study recommends mobilizing public to participate in health service delivery, introduction of new strategies and innovations, filling vacancies and enhancing competency of the staff, regularizing the internal auditing mechanism, improving the efficiency and effectiveness of the health service delivery through Five Year Plan and enhancing Public-Private Partnership in health service delivery