Public sector management and health service delivery in Uganda: a case of Kakumiro local government.

Abstract

The study examined the relationship between Public Sector Management and public health service delivery. The independent variable is Public Sector Management with key dimensions that included political decentralization, monitoring and public service work ethics dependent variable is public health service delivery with service indicators such as equitable accessibility, timely delivery, availability of health equipment and citizen satisfaction. The study was guided by the following Research Objectives to examine the contribution of health facility leadership towards public health service delivery, to evaluate the influence of Local Government monitoring on health service delivery and to assess the influence of public service work ethic on health service delivery in Kakumiro district. The study adopted a Pragmatism research paradigm that refuses to get involved in the contentious metaphysical concepts such as truth and reality. Instead, it accepts that there can be single or multiple realities that are open to empirical inquiry (Creswell and Clark 2011). The questionnaire and interview guide were the main instruments of data collection. Quantitative data was analyzed using frequency counts, means and percentages while qualitative data was analyzed by tallying the numbers of similar responses. Data editing coding the data and cleaning was done after data has been collected to ensure that all mistakes made by respondents was cleared then entering the data into the computer for analysis and summarizing the data. The findings of the study discovered that, malaria (37%) stood as the main type of health challenge faced by most household in Kakumiro district. Generally, malaria (37%) and typhoid (23%) are the major threats to the lives of households in Kakumiro district accounting for 60% of responses on common diseases experienced by households. Most local community members in Kakumiro obtain medical care from government facilities (57%). About 76% of households cover distances of between 0 km to 2 km and the least number of households (11%) cover a distance of above 4 km. Most (40%) of the respondents reached for this study, indicate that patients spend between 30 mins and 1 hour to receive treatment from the health facilities visited in Kakumiro district. District health teams on the other hand supervised health facilities and held quarterly review meetings with officials in-charge of health facilities. It is during such meetings that the in charge facilities report the accomplishments made, challenges faced and also present their plans to deal with such challenges faced and plans for the facility in general. This study strongly recommends for the establishment of M&E units in health facilities who report directly to the M&E unit in the MoH. This will expedite the process of reporting and tracking of performance for improved service delivery. Funding and supplies featured as critical factors undermining efficient and effective process of service delivery in Kakumiro district. This study therefore recommends a digitized system of tracking release and utilization of funds and supplies. It is envisaged that this will FastTrack utilization of funds and medical supplies and thus enhance transparency and accountability