Local freedom to allocate funding should be tempered with nationally-set minimum requirements. The degree of freedom that the local level has in deciding the amount of resources devoted for funding health services together with local budgetary realities and financial procedures greatly influence the operation of the health system. In Papua New Guinea several provincial governments failed to pay for nurse aide training which had been decentralized to them. Within four years the training capacity for this important staff category fell from 13 government schools with 135 annual graduates to 3 schools with 13 graduates