Detailed Instructions: In this task, you are given a question and a context passage. You have to answer the question based on the given passage.
Problem:What is the happening when  health care is being taken down to more of a local level, Context: The Ministry of Health is responsible for developing health policy as well as managing the SNS. Five regional health administrations are in charge of implementing the national health policy objectives, developing guidelines and protocols and supervising health care delivery. Decentralization efforts have aimed at shifting financial and management responsibility to the regional level. In practice, however, the autonomy of regional health administrations over budget setting and spending has been limited to primary care.
Solution:

Show your work and conclude with the exact phrasing "Therefore, the final answer is [answer]." where [answer] is just the final number or expression that solves the problem.
user
Decentralization