PATHS Final programme report: "Togetherness in Health" the Enugu ...

Section 5:ChallengesWhilst there were some very positivechanges in the functioning of the healthsystem and in the delivery of services,many challenges remain.1) By early 2008 the State Government was not yet supporting regular monthly releases so that theconstituent bodies of the District Health System could run their respective services. Apart froma six month period between September 2006 and March 2007, a very significant funding gapremained an issue. This had four main effects:••Constrained the process of bringing health services up to a basic level of provisionHampered the efforts of the Boards and Authorities in implementing the DHS• Negatively affected the enthusiasm and drive of those individuals who were committed tochange• Provide an excuse for individuals who were resistant to the health reform efforts to not doanything.2) Building the capacity of many staff to absorb and respond to the change brought about by farreachinghealth reform can be problematic. This was particularly the case for those individualswho had been appointed to posts through patronage rather than ability.3) Resistance to the reform process by those who saw themselves as the “losers” in terms of theirprevious responsibilities and their revised roles, particularly those in the most senior positions,was a reality.“Togetherness in Health” the Enugu Experience in Health Sector Reform, 2002-2008 71