All of the investigation was entered for the MS Access 2007 (Microsoft Inc

All of the investigation was entered for the MS Access 2007 (Microsoft Inc

, Redmond, WA, USA), after cleaning and validation. We used SPSS 20.0 (SPSS Inc) and R 3.2.1 for data analysis. The proxy for decentralization was existence of registered RKS – we considered it as an input. Perception satisfaction of the health workforce, generally considered as process indicators, were our immediate outputs. I) Perception about RKS’ influence was studied by broadly categorizing the health system-related factors into domains of local self-governance, functioning of health units, service delivery and local participation. II) Perceived importance of and satisfaction of respondents with the following provisions were studied in particular: infrastructure, funds availability, quality of services, behaviour of service providers, and community participation. III) For PD-NPD comparison of mean scores, multi-item composite scores were developed on individual-centric performance; organization-centric performance; patient-centric performance; future responsibilities to be entrusted to RKS; importance of individual-and organization-centric performance; and satisfaction with individual-and organization-centric performance. IV) On the basis of regression analysis, predictors of governance and satisfaction at work were identified. Descriptive statistics (mean, median, SD) and linear regression models were used. All continuous variables were described in terms of Mean (+/? SD), Median and their Range. Categorical variables were presented in frequency tablesparative analysis of results was carried out to analyze PD-NPD differences. We used Chi square test and independent t-test of significance for ordinal and continuous variables, respectively. P value of <0.05 was considered as ‘significant', and of <0.001 as ‘highly significant'. Open-ended responses, on the other hand, mainly contained descriptive suggestions to improve functioning of health units. We undertook thematic analysis of those responses and summarized the key findings.

Reputation out of respondents

A sample of 130 health workers responded to the questionnaire (N = 59 in PD and N = 71in NPD) which comprised of 63 males and 67 females. The proportion of male and female respondents was evenly matched at 48.5 and 51.5 %, respectively, in PD and NPD (p = 0.886). The respondents had a mean age of 43.4 years (SD ± ). There was no significant difference in the mean age of respondents between PD ( ± ) and NPD ( ± 9.25) (t = ?1.009, p = 0.315). However in PD, higher proportion of health workers was < 35 years age (PD = 36.2 %; NPD = 21.1 %; p = 0.006). Forty percent of respondents was MOs/AYUSH MOs, 14.6 % SNs, 13.1 % pharmacists, and the rest 32.3 % respondents comprised of LTs, LHVs, MPHSs, and PHEOs.

Local worry about-governance

About three-fourth (72.4 %; N = 130) of total respondents felt that there was remarkable improvement in the infrastructure of the facilities owing to the efforts of RKS (PD = 81.4 %; N = 59 and NPD = 65.2 %; N = 71; p =0.001). About 76 % of respondents felt that due to influence of RKS staff absenteeism had reduced (PD =74.5 %; best married hookup apps NPD = 48.5 %; p = 0.002). With respect to availability of funds, 71.2 % of respondents attributed higher availability of funds to functioning of RKS (PD = 84 %; NPD = 61.8 %; p <0.001). When asked as to whether or not there was any improvement in the overall governance level in the health unit, three-fifth (60 %) of them opined that there was ‘high' or ‘very high' level of improvement (PD = 74.5 %; NPD = 48.5 %).

Functioning away from health tools

About 85 % of respondents felt that RKS positively influenced the motivation of the health workforce deployed in the sample health units. There was no significant PD-NPD difference in this perception (p = 0.115). Similarly about 85 % of total respondents opined that due to the influence of RKS there was a remarkable improvement in the work culture of the health units (PD = 49.1 %; NPD = 24.3 %; p = 0.010). Eighty eight percent (88 %) of health workers felt that the performance of health units had improved in last 5 years and that such improvements were owing to the influence of RKS (p = 0.007). About three-fourth of respondents viewed that there was ‘high’ or ‘very high’ level of improvement in the satisfaction level of health workers because of the decision-taking abilities of RKS (PD = 56.4 %; NPD = 28.6 %; p < 0.001). Further, 69.3 % of respondents felt that RKS was effective in improving the quality of health service delivery. About one-fifth of respondents ranked the efficiency of RKS as ‘average', and about 9 % ranked it to be ‘ineffective'. Such perceptions varied significantly between the district categories (p <0.001); as compared to PD, higher proportion (85.9 %) of respondents was happy with the manner the RKS was governing the peripheral health units.


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