Acknowledgments

This special study was undertaken as part of the evaluation carried out by Mott MacDonald Ltd and the Centre for Development Management (CDM) on behalf of the Bill and Melinda Gates Foundation.

This Special Study 3 was written by Dr Janet Gruber, with inputs by Rachel Phillipson and Professor Maureen Chirwa.

We are extremely grateful to all the key informants who gave time from their busy schedules to talk to us about Kuunika, decentralization and District health services.

Special thanks to the Centre for Development Management (Malawi survey company): Bright, Wingston, (enumerators).

We are also grateful for support and comments from Cooper Smith