Readiness and Impact of Digital Public Financial Management Systems at Uganda's Health Frontlines
1
Health Financing, Clinton Health Access Initiative, Kampala, Uganda
2
Division of Sector Policy and Planning, Ministry of Health, Kampala, Uganda
3
Public Finance Management, Ministry of Local Government (REAP), Kampala, Uganda
Popul. Med. 2026;8(Supplement Supplement 1):A880
ABSTRACT
BACKGROUND:
Uganda is advancing digital public financial management (PFM) reforms through the rollout of HMIS001 for standardized planning and budgeting and the Simplified Computerized Accounting and Reporting Tool (SCART) for financial reporting at lower-level health facilities. Because the national Integrated Financial Management System (IFMIS) does not extend to frontline facilities, SCART addresses a critical governance gap. However, facility-level digital PFM remains constrained by fragmented platforms, limited interoperability, inconsistent nomenclature, and duplicative data entry. This study assessed readiness for digital PFM adoption and documented early implementation outcomes of DHIS2-based HMIS001 and SCART in two pilot districts.
METHODS:
A government-led, partner-supported facility readiness assessment was conducted in Kassanda and Kakumiro districts, examining digital infrastructure, software functionality, and human resource capacity. A five-day digitization training was delivered to 50 district and facility staff, leading to onboarding of six HC IV facilities onto HMIS001 and SCART, with FY 2025/26 budget data uploaded and accounts established.
RESULTS:
Readiness was mixed. Although 94.6% of facilities had functional computers, 97.3% had designated HMIS 001 data staff, and 94.6% had financial reporting personnel, only 47% met the full readiness triad of functional computer, reliable electricity, and internet connectivity. Updated software systems were available in 77% of facilities, but only 34% had backup power or antivirus protection, making power instability a key sustainability risk. All six HCIV facilities were successfully onboarded, enabling remote visibility of facility-level budget execution through the SCART dashboard. Limited computer literacy highlighted the need for continued mentorship.
CONCLUSIONS:
This pilot demonstrates both feasibility and constraints of facility-level digital PFM in Uganda. Early implementation suggests improved data accuracy, reduced reporting time, and enhanced confidence in financial tracking. Harmonizing HMIS001 and SCART with the Programme Budgeting System and Chart of Accounts offers a scalable pathway to improved transparency, accountability, and efficiency in primary health care financing.
Uganda is advancing digital public financial management (PFM) reforms through the rollout of HMIS001 for standardized planning and budgeting and the Simplified Computerized Accounting and Reporting Tool (SCART) for financial reporting at lower-level health facilities. Because the national Integrated Financial Management System (IFMIS) does not extend to frontline facilities, SCART addresses a critical governance gap. However, facility-level digital PFM remains constrained by fragmented platforms, limited interoperability, inconsistent nomenclature, and duplicative data entry. This study assessed readiness for digital PFM adoption and documented early implementation outcomes of DHIS2-based HMIS001 and SCART in two pilot districts.
METHODS:
A government-led, partner-supported facility readiness assessment was conducted in Kassanda and Kakumiro districts, examining digital infrastructure, software functionality, and human resource capacity. A five-day digitization training was delivered to 50 district and facility staff, leading to onboarding of six HC IV facilities onto HMIS001 and SCART, with FY 2025/26 budget data uploaded and accounts established.
RESULTS:
Readiness was mixed. Although 94.6% of facilities had functional computers, 97.3% had designated HMIS 001 data staff, and 94.6% had financial reporting personnel, only 47% met the full readiness triad of functional computer, reliable electricity, and internet connectivity. Updated software systems were available in 77% of facilities, but only 34% had backup power or antivirus protection, making power instability a key sustainability risk. All six HCIV facilities were successfully onboarded, enabling remote visibility of facility-level budget execution through the SCART dashboard. Limited computer literacy highlighted the need for continued mentorship.
CONCLUSIONS:
This pilot demonstrates both feasibility and constraints of facility-level digital PFM in Uganda. Early implementation suggests improved data accuracy, reduced reporting time, and enhanced confidence in financial tracking. Harmonizing HMIS001 and SCART with the Programme Budgeting System and Chart of Accounts offers a scalable pathway to improved transparency, accountability, and efficiency in primary health care financing.
| eISSN: | 2654-1459 |
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