effect of current political decentralisation policy on health service delivery in local governments, a case of a district local government
1
Clinical Epidemiology Unit, Makerere university, Kampala, Uganda
2
School of Management Sciences, Uganda Management Institute, KAMPALA, Uganda
3
Management, Uganda Martyrs University Nkozi, Kampala, Uganda
Popul. Med. 2026;8(Supplement Supplement 1):A3634
ABSTRACT
INTRODUCTION:
health service delivery is enhanced by implementation of context relevant policies. despite adoption of political decentralisation policy reforms like delegation of planning, budgeting, oversight, policy formulation and legislation to subnational governments, health service performance short falls have remained persistent in uganda. this study provided additional evidence for the effect of current political decentralisation policy on health service delivery in uganda taking a case of mukono district local government, uganda.
METHODS:
we used a cross sectional study design with qualitative and quantitative approaches. purposive and also simple random sampling was used to recruit 319 participants. quantitative data was collected using an interviewer guided questionnaire. key informant interviews gathered qualitative data and was examined thematically. pearson’s correlation and linear regression methods determined the relationship and effect between variables.
RESULTS:
most of the study participants had certificate level of education 131 (41.1%) followed by degree level 94 (29.5%) and diploma level 70 (21.9%). about 55 (17.2%) were top level of management, while 69 (21.6%) and 194 (60.8) were in middle and lower level management. planning and budgeting had a weak positive relationship (r=0.265, p-value=0.000), direction setting had a weak positive relationship (r=0.455, p value=0.000), oversight had moderate positive relationship (r=0.603, p value=0.000). overall, political decentralization was a weak predictor for health service delivery (adjusted r squared=0.374). oversight practices had the highest positive effect (beta=0.517) on health service delivery followed by direction setting (beta value=0.177) and planning and budgeting (beta=-044).
CONCLUSIONS:
political decentralization was a weak significant predictor for health service delivery. variables that were not examined in this study continued to decipher the disparity in health service delivery in mukono district. efforts aimed at improving planning, budgeting and direction setting yielded weak outcomes on health service delivery. however, strengthening in oversight practices yielded moderately strong outcomes in health service delivery.
health service delivery is enhanced by implementation of context relevant policies. despite adoption of political decentralisation policy reforms like delegation of planning, budgeting, oversight, policy formulation and legislation to subnational governments, health service performance short falls have remained persistent in uganda. this study provided additional evidence for the effect of current political decentralisation policy on health service delivery in uganda taking a case of mukono district local government, uganda.
METHODS:
we used a cross sectional study design with qualitative and quantitative approaches. purposive and also simple random sampling was used to recruit 319 participants. quantitative data was collected using an interviewer guided questionnaire. key informant interviews gathered qualitative data and was examined thematically. pearson’s correlation and linear regression methods determined the relationship and effect between variables.
RESULTS:
most of the study participants had certificate level of education 131 (41.1%) followed by degree level 94 (29.5%) and diploma level 70 (21.9%). about 55 (17.2%) were top level of management, while 69 (21.6%) and 194 (60.8) were in middle and lower level management. planning and budgeting had a weak positive relationship (r=0.265, p-value=0.000), direction setting had a weak positive relationship (r=0.455, p value=0.000), oversight had moderate positive relationship (r=0.603, p value=0.000). overall, political decentralization was a weak predictor for health service delivery (adjusted r squared=0.374). oversight practices had the highest positive effect (beta=0.517) on health service delivery followed by direction setting (beta value=0.177) and planning and budgeting (beta=-044).
CONCLUSIONS:
political decentralization was a weak significant predictor for health service delivery. variables that were not examined in this study continued to decipher the disparity in health service delivery in mukono district. efforts aimed at improving planning, budgeting and direction setting yielded weak outcomes on health service delivery. however, strengthening in oversight practices yielded moderately strong outcomes in health service delivery.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
