Management Of Community Based Health Projects by the Decentralized Local Governments in the Western Province Of Rwanda

ABSTRACT This study investigated the management of CBHP by the decentralized local governments in western province of Rwanda. It was carried out basing on three specific objectives: To identify the various CBHP being managed by local governments, to investigate how local governments are managing CBHP and to find out challenges faced by the local governments in managing the CBHP. The study used a descriptive research design, The study population comprised of 432, from which a study sample of 208 respondents were chosen, the study used stratified method to select the category of respondents to be included in the sample, the purposive technique of sampling to select district health officials and simple random sampling to select Community opinion leaders. A self-administered questionnaire was used as the main method of data collection. The findings shows that CBHP are not well managed by the local governments in western province of Rwanda, the participation of local community members and other stakeholders in the planning is low; The founds resources are still insufficient; the projects’ time schedule are not respected,; the recruitment of projects’ staff is not transparent; the salary and work conditions of projects’ staff are insufficient; and the monitoring and evaluation is not well implemented. Findings shows also that financial constraint, Lack of M&E, Lack of qualified personnel, Political interference, Remoteness of areas and low participation of beneficiaries ar e the major c hallenges facing local governments in managing CBHP. The study r ecommends that local governments should: Involve all stakeholders at every stage of projects’ planning; Reinstall the recruitment commission which will be transparent; Hire qualified staff; Train all stakeholders; Increase the salary and improve the work conditions of staff; Stop interfering on the projects’ activities; Put in place a regular and effective monitoring and evaluation system, Develop partnerships with other development agencies to gain financial support and involve communities in terms of resources mobilization and the central government should increase its financing to the CBHP.

TABLE OF CONTENTS

Chapter Page

ONE THE PROBLEMANDITSSCOPE 1

Background of the study 1

Statement of the problem 3

Purpose of the study 4

Research objectives 5

Research questions 5

Scope of the study 6

Significance of the study 6

Operational definitions of key terms 7

Conceptual framework 9

Two REVIEW OF RELATED LITERATURE 11

Introduction 11

Concepts, ideas, opinions from authors /experts 11

Concept of management 11

Concept of decentralization 13

Decentralization policy and local government in

Rwanda 15

Related studies 18

Function of management 18

Monitoring and evaluation 25

Local government in planning, implementation,

monitoring and evaluation process 28

vi’

Three METHODOLOGY 36

Introduction 36

Research Design 36

Research Population 37

Sample Size 37

Sampling Procedure 38

Research instruments 38

Validity and reliability of the instrument 39

Data gathering procedures 40

Data analysis 40

Ethical Considerations 40

Limitations of the study 41

FOUR PRESENTATION, ANALYSIS AND INTERPRETATION OF

DATA

42

Introduction 42

Presentation of findings 42

Community based health projects managed by the local

governments 42

Management of community based health projects by local

governments 45

Challenges faced in the management of community

health projects by the local governments 59

Strategies to solve challenges experienced by the local

governments in the management of community health

projects 61

Five FINDINGS, CONCLUSIONS AND RECOMMENDATIONS 64

Introduction 64

Findings summary 64

Summary of findings on the identification of various

community based health projects being managed

by local governments. 64

Summary of findings on the management of

community based projects by local governments 65

Summary of findings on the challenges faced by local

governments in managing community based health

projects. 67

Conclusions 68

Recommendations 69

Suggestions for further study 71

REFERENCES 72

APPENDICES 77

Appendix I. Questionnaires 77

Appendix II. Researcher’s curriculum vitea 77

Appendix IlL Introductory letter 87