Decentralization and Health Service Delivery in Ruteete Sub County, Kagadi District Local Gov’t in Western Uganda

TABLE OFCONTENTS

DECLARATION

APPPROVAL

DEDICATION Ii

ACKNOWLEDGEMENT iv

TABLE OFCONTENTS v

LIST OF TABLES viii

ACRONYMS ix

ABSTRACT

CHAPTER ONE 1

INTRODUCTION 1

1.1 Background to the study 1

1.2 Statement of the problem 4

1.3 Purpose of the study 5

1.4.1 General objective 5

1.4 Objectives of the study 5

1.5 Research Questions 5

1.6 Scope ofthe study 5

1.6.1 Geographical scope 5

1.6.2 Content scope 5

1.6.3 Time scope 6

1.7 Significance of the study 6

1.8 Theoretical perspectives 6

1.8.1 Public-choice theory 6

1.8.2 The Marxist theory 7

CHAPTER TWO

LITERATURE REVIEW g

2.0 Introduction 9

2.1 Objectives of Decentralization in Uganda 10

2.2 Performance of personnel 13

2.3 Staffing 14

2.5 District Personnel and National Reforms 16

2.6 Personnel Facilitation and Motivation 16

CHAPTER THREE 18

METHODOLOGY 18

3.0 Introduction 18

V

3.1 Research Design .18

3.3 Population of the study 18

3.4 Sample size and Sample Technique 18

3.5 Data Collection Methods and Instruments 19

3.5.1 Questionnaire 19

3.5.2 Interview 19

3.6 Source of Data , 20

3.6.1 Primary data 20

3.6.2 Secondary data 20

3.7 Procedure for data collection 20

3.8 Data management and analysis 21

3.9 Limitations of the study 21

4.0 Ethical considerations 21

CHAPTER FOUR 22

FINDINGS 22

4.1 Introduction 22

4.2 Socio- demographic characterists 22

4.2.1 Age of the respondents 22

4.2.2 Sex of the respondents 23

4.2.3 Marital status of the respondents 23

4.2.4 Educational levels of the respondents 24

4.2.5 Occupational Background 25

4.3 How Local Governments Deliver Health Services 25

4.3.1 Attending to Performance Meetings 25

4.3.3 Consultation of the Local Population on Health Service Delivery 26

4.3.4 Institutions responsible for the Delivery of Health Services 27

4.2.5 Community Participation in Implementation of Health Related Programmes 28

4.3.6 Role Played by the respondents in the Implementation of Various Health Policies in

Ruteete Sub County 29

4.4 Constraints hindering health service provision in Ruteete Sub County 30

4.5 Suggested Solutions to above challenges 31

CHAPTER FIVE 32

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS 32

4.6 Introduction 32

4.7 Summary 32

4.8 Conclusions 34

vi

4.9 Recommendations .34

REFERENCES 36

APPENDICES 39

APPENDIX 1: QUESTIONAIRE FOR HEALTH SERVICE USERS 39

APPENDIX 2: INTERVIEW GUIDE 44