Given the following passage  "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.",  answer the following question. Note that the answer is present within the text.  Question: What is the happening when  health care is being taken down to more of a local level
Answer:
Decentralization