The reform of the Health System in South Africa is now 6 years down the line. The DHS is the vehicle for providing Primary Health Care, an important pillar to the reform process. The DHS allows managers to take charge of the district services and available resources. For this to happen, districts and provinces require a structured approach and integrated strategy to get resource-related decision making powers and capacity away from the centre.
Decentralisation is therefore a key concern in district development.
Provincial offices are often concerned that districts are not yet ready for taking on new responsibilities, especially the management of financial resources. The districts on the other hand are often of the opinion that decentralisation is too slow and that they could do more if they could take charge of all services and finances. Yet, districts are also very aware of the capacity gaps they have. These gaps are usually the result of a lack of training,exposure and experience and a lack of skilled people in the district. Through this process the district identified financial management as a key area requiring intervention.