The thesis with the title: “Health and decentralization, a study of the impact of decentralization on health services in Ghana”, studied the nature of community participation and how the process as influenced the use of modern health facilities/services. The study was conducted in two communities of the Central Gonja District of the Northern Region in Ghana. The study revealed that local participation is weak. This is because local beneficiaries only participate actively in resource mobilization that is, making available community land for the construction of health centers and nurses’ quarters, providing labour and other voluntary services. Other forms of participation such as needs assessment are narrow as people are sometimes involved in identifying their health needs. Management and leadership as forms of participation revealed that local participation is extremely weak. Issues of managing the day-to-day activities of the various health centers are seen as a sole responsibility of service providers and health workers. On access to health services, most of the people still find it difficult to pay for health services claiming that costs of treatment is high. The study showed that only ¼ of the population in the district is being able to register with the District Mutual Health Insurance Scheme. This, coupled with poor attitude of health workers, inadequate general health equipment and drugs, and the unfavourable operational hours of these health centers have made local users resort to alternative methods of treatment such as self medication and treatment by the traditional healers. However the physical presence of health workers and facilities/services provide some form of security to beneficiaries against emergency health cases.