The aim of decentralization is to improve the delivery of basic services to the local population and to provide them with an institutional framework conducive to the establishment of democracy. This development approach involves transferring powers and resources, particularly financial resources, to the communes. From now on, central government will have to relinquish these powers and resources. However, the transfer of financial resources to communes for the construction, maintenance, repair and operation of health and social promotion centers (CSPS) and medical centers (CM) remains insufficient. To this end, an analysis of the perceptions of the various stakeholders was carried out. According to data collected from the MATD 2011-2016, out of a total of ninety-three billion nine hundred and thirty-four million five hundred and sixty-six thousand francs (93,934,566,000) earmarked for the competence, the communes have benefited from only 28% of the financial resources earmarked for the exercise of the competence. This significant gap demonstrates the scale of the problem.