Monitoring resource allocation at the district level in Uganda: implications and challenges

Like most developing countries, Uganda works on a very tight health budget and the government has to ensure strict principles of efficiency and equity in the allocation and use of the minimal resources. One of the strategies in the process of improving delivery of public services has been to decentralise them. The district local government is responsible for the planning process, data management, resource allocation and co-ordination with the central government. However the capacity of the districts to stick to the principles of efficiency and equity is not a given. In Uganda, the health system has been further devolved with the creation of health sub- districts. Because there are no clear guidelines from both local and central governments on how to ensure equity in resource allocation at the district level there have been arguments that resources from the centre to the district are not necessarily equitably allocated at the sub- district. The principle of equity that would seem of relevance in this case is that of providing resources to those in most need (most deprived) given the minimal resources available. This study was done to assess how health resources are allocated between sub-districts relative to the level of need/deprivation in each sub district and in the process suggest a resource allocation formula for the district. Using mainly data from a rapid household hold survey and simple additive averaging to aggregate variables to create a deprivation index, the study showed that three sub-districts in Luwero district differed in the level of deprivation and the most deprived sub-district was actually under-resourced. The study therefore showed that there is room for using simple indices in a resource allocation formula at the district level so that budgets in the future are allocated to the most deprived areas hence maintaining the central government goal of ensuring equity in the use and allocation of minimal resources that are usually available.

Grantor dc:publisher.institution

Department of Public Health and Family Medicine

Year dc:date.issued

2004

Author dc:creator

• Kamoga, Edward Nelson B

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/11427/8632

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/8632