OBJECTIVES: To assesses the extent of varying perspectives between health workers and community members’ perception of decentralization and how such variation in views could affect the effective health services planning and management in the Nanumba North District, Ghana. METHODS: A descriptive analytical cross sectional survey with randomly selected community members aged 18 or more years and health staff was undertaken from May – September 2009. Data collection was done with the use of questionnaire and interview guide administered by university trained research assistants to 186 respondents; 120 community members, 66 health staff who had stayed or worked in the district for the past 6-12months. Data was analysed into descriptive statistics using the Statistical Package for Social Sciences (SPSS) version 15.0. The significance or otherwise of the differences in perspectives was ascertained using chi-square or fishers exact test with p-values of 0.05 or less and at 95% confidence interval. The study had ethical clearance and Informed consent was sought from respondents. RESULTS: A majority of health workers were females 74.2%, and young with average of 31.5yrs (SD, 9.3) and had worked for <5yrs, 56.1%. Community members, 47.5%, were equally quite young but slightly older, mean years 34.8, (SD 8.4), than health staff, and had lived in the community for <5yrs. There was significant differences in perception between health staff of whether or not the district management team (DHMT) was decentralised, p<0.05, and in perception regarding health planning process and management of finances between health staff and community members, p<0.05. CONCLUSIONS: Differences in perception between health staff and community members partly account for low community involvement in health planning and management, health activities and utilisation of health service. A study involving many DHMTs will be needed to make a case for policy change as the study focused on only one district.