This study examined the effect of decentralisation on the performance of Tororo district Health personnel; it assessed the personnel performance in terms of their quantity and quality, personnel accessibility to local people, the clients’ satisfaction of personnel services and constraints to personnel performance under decentralisation. In the process, it followed up the personnel performance factors; that is performance definition or job expectation, performance facilitation and encouragement, and the quality of service. The research used a descriptive case-study design. Both quantitative and qualitative data collection methods were utilized. The study targeted personnel and politicians at district, municipality, subcounty and parish levels. It also targeted NGOs and the private sector, and the health services consumers in Tororo district. Results show that decentralisation had both positive and negative effect on the performance of the Health personnel of Tororo district. The improvement of the personnel’s ability to know what they are expected to do on their jobs led to improvement on personnel quality as being focused in their performance. Understaffing with a staffing gap of 70%, under-qualified staff especially in lower cadre level and a non-existent District Service Commission; reduced the quality of staff and coupled with lack of funds for recruitment this constrained personnel performance.