This book presents findings from a survey of sixteen functional health units at four different levels of local governments in Uganda. Uganda is one of the few countries in the developing world to systematically decentralize the delivery of basic health services to locally elected local governments. Its health policy has also been guided by the Bamako Initiative to encourage and sustain community participation in health services. The survey data provide systematic evidence on how health management structures of decentralization are functioning at the level of local governments to deliver health services. The writer carried out the study basing on the fact that most deaths in Uganda are due to conditions that could otherwise be preventable. The phenomenon could be reduced through meaningful community participation and the belief was that the decentralized system of health service management would offer an environment for such participation. Thus attention should be drawn to processes that involve community participation but with special attention to vulnerable groups, especially the rural poor, women, and children.