Fiscal Decentralisation and the Performance of Health Sector in Kabale District, Uganda.

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Kabale University


The study was to establish the impact of Fiscal Decentralization on health service delivery in Kabale District. This was based on the objectives namely; to identify the contribution of fiscal decentralization on health service delivery in Kabale district, to establish the factors that affect fiscal decentralization on health service delivery in Kabale District, to find out the solutions on challenges facing fiscal decentralization on the health service delivery in Kabale district. The study used exploratory and descriptive research design which involves analysis and the use of words because it enabled the researcher to draw valid and dependable conclusion and recommendations. The design of the study was built on a causal relationship based on the results from some of the data collection tools which are questionnaires, oral interviews and observations of the researcher. The study used questionnaire, interviewing and documentary review that gave the researcher the inner understanding of the study. Those methods that helped the researcher to collect data from the field of study.196 respondents were selected for the study whereby, 84 were male and 112 were females. From the findings most respondents agreed on factors that influence fiscal decentralisation on health service delivery; such as supportive supervision, sensitization, administrative and management systems, revenue collection and administration. Findings indicate that fiscal decentralization can improve the efficiency of public service delivery but only under specific conditions. First, the decentralization process requires adequate political and institutional environments. Second, a sufficient degree of expenditure decentralization seems necessary to obtain favorable outcomes. Third, decentralization of expenditure needs to be accompanied by sufficient fiscal decentralization of revenue. Absent of those conditions, fiscal decentralization cannot be delivered. It was recommended that the government takes steps stem the fragmentation's in health service delivery in the country, provide the needed funding for health service delivery and in the medium to long term, detach the Department of Ministry of Health and create an all new Ministry to encompass and allied agencies in the country, Government must increase more funds in budgeting for the Ministry of Health, MOH should mobilize all health agents to solve problems and challenges facing health sector, MOH should renovate all health buildings, put up more health facilities, improve on transport system, and increase the number of doctors.



Fiscal Decentralisation, The Performance of Health Sector