of factors. Interest in and commitment to primary care development within the
MOPH was relatively low compared to hospital care. At the operational level,
resource allocation was biased to favour district hospitals rather than the whole
district health system28. Since the district hospital directors were usually acting as
fund holder and chair of the CUP governing board, some used their position to
prioritize curative hospital services over primary care development.
Other accountability concerns
The governance assessment revealed a number of other concerns. The length
of time it takes to release reports and documents, and the fact that they are
not particularly reader friendly, have been impediments to accountability and
well-informed participation. Hospital accounting systems were found to be
insufficient and not able to disclose accurate and timely information and data.
Lack of accurate and timely empirical data (routine data and research) about
financial performance and health-care performance (outpatient care, disease
prevention and health promotion) significantly compromised policy formulation,
monitoring and evaluation.