Fiscal Decentralization And Health Service Delivery In Iuira Town Council, Wakiso District, Uganda

Abstract

The study sought to examine fiscal decentralization and health service delivery in Kiira Town

Council, Wakiso District, Uganda. The study objectives were; to establish the level of fiscal

decentralization in Kiira Town Council, Wakiso District. Uganda, to examine the effect of fiscal

decentralization on health service delivery in Kiira Town Council, Wakiso District, Uganda and

to determine the relationship between fiscal decentralization and health service delivery in Kiira

Town Council, Wakiso District, Uganda. This study was used descriptive research design. The

purpose of employ this method was to describe the nature of a situation, as it exists at the time of

the study and to explore the causes of particular phenomena. The descriptive approach was also

quick and more practical. The population of Kiira Town Council, Wakiso District was 1 8000

people (Uganda Demographic Survey, 2016). The research population of 130 as a target

population representing district development officers (15), community leaders (12), peasants (85)

and District health officials (18). The study used Sloven’s formula to determine the sample size of

the actual respondents and the sample size is 98 respondents. The researcher used varieties of

sampling which included: Purposive and random sampling. Data was collected from primary and

secondary sources using questionnaires and interviews. After collecting data, the researcher

organized well-answered questionnaire, data was edited and sorted for the next stage. The data

was presented in tabular form, pie charts and bar graphs with frequencies and percentages. It was

found out that fiscal decentralization can improve the efficiency of public service delivery through

preference matching and allocative efficiency where by 20 (20.4%) respondents strongly

disagreed. The results presented in the table above show that Fiscal decentralization can improve

the efficiency of public service delivery through preference matching and allocative efficiency

where by 21 (21.4%) respondents disagreed. The study concludes that fiscal decentralization can

improve the efficiency of public service delivery through preference matching and allocative

efficiency. Local governments possess better access to local preferences and, consequently, have

an informational advantage over the central government in deciding which provision of goods and

services would best satisfy citizens’ needs. There needs to be more discussion and agreement on

the degree of balanced distribution of fiscal resources among different regions. The study

recommends that the revenue-sharing formula should be transparent. Furthermore, there is need

to create some incentives for the development of own-source revenue at the regional and local

level.

Table of Contents

Declaration ii

Approval iii

Dedication iv

Acknowledgement v

Table of Contents vi

List of tables ix

List of Acronyms x

Abstract xi

Chapter One

Introduction

.1 Background of the Study

1 .1 .1 Historical perspective

1 .1 .2 Theoretical perspective

1 .1 .3 Conceptual perspective 2

1 .1 .4 Contextual perspective 4

1.2 Statement of the problem 6

1.3 General Objective 6

1 .4 Research questions 7

1.5 Scope of the Study 7

1.6 Significance of the Study 7

Chapter Two 9

Literature Review 9

2.1 Theoretical Review 9

2.2 Related literature 10

2.2.1 Level of fiscal decentralization in Kiira Town Council, Wakiso District, Uganda 10

2.2.2 Effect of fiscal decentralization on health service delivery in Kiira Town Council, Wakiso

District, Uganda 13

2.2.3 Relationship between fiscal decentralization and health service delivery in Kiira Town

Council, Wakiso District, Uganda 14

2.3 Conceptual Framework 17

vi

Chapter Three.19

Methodology 19

3.1. Research Design 19

3.2 Population 19

3.3 Sample 19

3.3.1 Sample size and sampling procedure 20

3.4 Data Collection Instruments 21

3.4.1 Interview Guide 21

3.4.2 Questionnaire 21

3.5 Validity and reliability 21

3.5 Data Collection Procedures 22

3.6 Data Management 22

Chapter Four 23

Data Presentation. Interpretation and Analysis 23

4. 0 Introduction 23

4.1 Description of respondents’ background information 23

4.1.1 Respondents by Gender 23

4.1.2 Respondents by Level of Education 24

4.1 .3 Respondents by Age 25

4.2 Findings on level of fiscal decentralization in Kiira Town Council, Wakiso District 25

4.2.1 Fiscal decentralization can improve the efficiency of public service delivery through

preference matching and allocative efficiency 25

4.3 Findings on effect of fiscal decentralization on health service delivery in Kiira Town

Council, Wakiso District, Uganda 30

4.4 Findings on relationship between fiscal decentralization and health service delivery in Kiira

Town Council, Wakiso District, Uganda 34

Chapter Five 38

Findings, Conclusions and Recommendations 38

5.1 Summary of findings and discussions 38

5.1.1 Level of fiscal decentralization in Kiira Town Council, Wakiso District 38

5.1.2 Effect of fiscal decentralization on health service delivery in Kiira Town Council, Wakiso

District, Uganda 40

5.1.3 Relationship between fiscal decentralization and health service delivery in Kiira Town

Council, Wakiso District, Uganda 42

VII

5.2 Conclusion.43

5.2.1 Level of fiscal decentralization in Kiira Town Council, Wakiso District, Uganda 43

5.2.2 Effect of fiscal decentralization on health service delivery in Kiira Town Council, Wakiso

District, Uganda 44

5.2.3 Relationship between fiscal decentralization and health service delivery in Kiira Town

Council, Wakiso District, Uganda 45

5.3 Recommendations 45

5.4 Suggestions for further research 46

REFERENCES 47

APPENDICES 49

Appendix I: Questionnaire 49

Appendix II: A map showing the location of Kiira Town Council, Wakiso District 52