Despite a well-articulated policy framework and effective use of the SWAp structure to coordinate donor activities through technical working groups, there are difficulties in achieving translation of SRH policy into decentralised operations at district level. While progress with maternal and neonatal mortality rates is encouraging, they remain unacceptably high, and with life expectancy at birth only 54 years for females and 52 years for males, and HIV prevalence at 12% in young pregnant women, the challenges are great. District health offices experience many challenges in balancing the requirements of both the MOH and the Ministry of Local Government. The mix.
