This study, Impact Assessment of Decentralization on Health Care Service Delivery was done atrnGozamin woreda of East Gojjam Zone Administration in Amhara National Regional state. Thernmajor objective of the study was to assess the impacts of decentralization on the health carernservice delivelY. The current status of health care services, the responsibilities and functions ofrnthe woreda health office, the level of community participation and the major challenges of thernworeda that hinder from providing quality health care services were. reviewed.rnMethodologically, a descriptive research design with qualitative research technique/ method wasrnemployed to collect the data for the study. The instruments used to collect the data arerninterviews, focus group discussions and field observations. Primary and secondary data wererncollected from different Health institutions in the Woreda as well as fi-om annual offiCial healthrnsector reports and documents. The analysis part was supported by legal and official documents.rnThe findings of the study revealed the recruitment of health personnel, collection of user fee,rnmanagement and supervision of health institutions, in-service training and career developmentrnof health workers are devolved to the woreda. The study also found that undertakingrnconstruction of health HCs and health posts is given to the woreda in a delegated form. Whereas,rnpurchasing of drugs alld other pharmaceutical equipments are highly centralized, controlled byrnthe regional governments. The health care service accessibility and coverage of the woreda inrnterms of expansion of health care institutions has shown all improvement, it reach 100%.rnHowever, shortage of health personnel (midwifery, lab technician and pharmacy technician),rnshortage of finance for duty service and per-diem payment, and drugs shortage are thernchallenges of the woreda health care delivelY system that affects the quality of the services.rnMoreover, according to the patients and }:ouseholds view, the costs of health care treatment isrnhigh as compared to the ability of most beneficiaries incomes, the free service scheme-which isrnvery impressive were abused by kebele officials and weak one to five and one thirty network orrngroups were also the challenges of Gozamin woreda health care service delivelY system.