This research aimed at identifying the main challenges that were faced in delivering health services in Amolatar, as a case study of new districts. Being a self funded study, the research focused on one sector of health service delivery, namely malaria curative service as the indicator for assessing the service delivery. Both the view points of the service providers and recipients of the services were assessed. Key aspects that were studied included: identifying the managerial, institutional, Technical capacity, community and other contextual challenges that were faced by the new district during the formative and transition stages. Both primary and secondary data were collected using mainly interview of Local Government(LG) staff and members of the communities they serve.