To make matters worse, at the operational level, healthcare facilities were compelled to borrow from their own regular stocks to compensate for failures in the supply of inputs for the free caesareans policy from the central level (erratic funding, incomplete kits).
In Laos, responsibility for public programmes was shifted from the central level to provincial and district levels.
Decentralization refers to the transfer of fiscal, administrative and political authority for health service delivery from the central levels of the Ministry of Health to alternate institutions, frequently district health systems [ 54].
Management for HRD at the central level, and various other levels of the health system, was strengthened with the responsibilities for HRD clearly established.
Apart from deciding the funds available for individual hospitals, the central level of Ministry of Health has less influence on the priority setting at health centre and hospital level where the interventions offered to a large extent are determined by self-referral of patients.
The key results of the interviews are presented in table 5. *Only when directly mentioned as reason for low enrolment At the central level of the Ministry of Health, the KI interviews indicated absence of a central, strategic policy on CHI.
The lack of information and research on which policy decisions could be based was a challenge at the time (Jönsson et al. 2007), and through the inclusion of some 40 health officials in nine different HSR projects in a number of provinces and districts, research capacity could increase at the same time as research results could be generated for policy decisions at the central level.
It is therefore very likely that the peripheral effects of resveratrol might compensate for the responses induced at the central level.
Another challenge was the cost of maintenance for the two systems at the central level.
At the district level, financial resources allocated by the central level for the cost of transportation are managed independently from subsidies for deliveries and emergency obstetric care.
