Decentralization of health services is often contentious in both developed and developing nations. The aim of this text book was to conduct an in depth examination of the nature and impact of health system decentralization, using primary care service users' and providers' perspectives. Decentralization of health policy is a difficult area to investigate due to the lack of conceptual clarity about decentralization itself and the complexities of analysing policy processes, especially the attribution of outcomes to particular policies. The study shows that decentralization of health services is positively associated with increased access and utilisation of services and improved service delivery. This book contributes to the topical debate about decentralised services through the exploration of different approaches to assess the impact of decentralization, offering alternative framework for analysis. This book will also become one of the reading texts for anyone involved in teaching and research about decentralization and health services.