Lack of clear demarcation of functions between central government and local authorities
in the Decentralization Act of 1999. This has led to confusion in the roles and responsibilities of
different levels of government, especially in provision of health and education services. The result
has been uncertainty and frustration amongst local authorities, some of whom have opted to
provide health and educational services while others have been unable to. Also central government
agencies have retained control over the majority of the service delivery units and hence provision of
health and education services. Because of lack of clear roles and responsibilities between different
levels of government there has not been adequate coordination of decentralization reforms with
sectoral reforms. Over the last decade the health and education sectors have also implemented
reforms through the introduction of a centrally managed Universal Health Care Scheme and the
National Education Act (1999) which set up 176 devolved Education Service Areas across the
countries and provided significant financial autonomy to schools. These sectoral reforms have
not been coordinated or calibrated with the decentralization reforms. On top of these issues,
there have been significant coordination challenges between the deconcentrated arms of the
central government at the provincial level and the new institutions of local self government that
were established through the decentralization process.