Democratic decentralization has been the agreed policy both at the state as well as at the national level. Panchayat Raj Institutions will be responsible in management of various socio-economic development programs including health in the coming years. The public Health Management skills have been deteriorated because of lack of expertise in public health of fast changing incumbents as health managers of districts. The decentralization process has taken the position without adequate preparing the ground for effective functioning of the health system in particular. Unless the personnel occupying the senior position of district, taluk or health institutions are equipped with public health management skills, there will be definitely no improvement in health status be it district or state. The Institute of Health Management Research, Bangalore has developed a model for capacity building of health care managers in Public Health Management comprising of knowledge and skills, that can turn out the district health system to be more responsive to the needs of the community.