Fiscal Decentralization On the Delivery of Health Services in Kasese Municipality, Kasese District

ABSTRACT The purpose ol the study was to examine the effect of fiscal decentralization on the delivery of health services in Kasese district, Kasese Municipality. This study was based on the following objectives: To examine the contribution of fiscal decentralization on the health structure in Kasese Municinality. To analyze the contribution of fiscal decentralization on Human Resource in Kasese Mui icipality. To determine the contribution of fiscal decentralization has on the availability of Irugs in Kasese Municipality. The study employed qualitative and quantitative approach whici aimed at describing the phenomena nature and patterns of the study. The study population wa~ 150 consisting of municipal health officers, the chairpersons, LC III, the sub county chiefs, ~.D.O, the mayor, health workers, members of the community. The sample size was selected u sing the table by Krejecie and Morgan cited by Amin, (2005) thus our study population of 50 was summarized to the sample size of 120 respondents. Self administration questionnaires and interview guides were used as means of collecting data from the respondents wi ile conducting research. The researcher analyzed data through use of sampling and sapling te hniques. Data was collected with both the aid of structural and non structured questions. The study Concluded that The fiscal decentralization policy has led to increased utilization of tl~e health facilities .the perception that the policy was good because it empowered the local comi ~iunity in terms of creating sense of ownership in the stakeholders, that has facilitated the sistainability of the public institution .in spite the views expressed ,the policy has failed to deal with drug shortages, inefficient utilization of the resources ,morale among the staff, retraining of the staff and better remuneration in order match effective implementation of the policy. Inc eased corruption: In sub-national governments officials are more likely to be subject to the ressures coming from local elites or other interest groups. In addition, subnational office s have more discretion than national ones. Lastly, sub-national governments’ institutions are less developed and skilled than the ones at the central level. so they may be less capable to con rol abuses of power/resources by public employees and officials. The study Recommended that Despite the negative finding still leading low efficiency of the Uganda’s local governm~. ut in channeling public funds to health care and hence to the better services ,as revealed by th this study. The following steps have suggested to enable health centre improve on her fiscal decentralization system to ensure health service delivery. Kasese District, must ensure that th. y hold continuous trainings on educating the locals on what exactly is the meaning of Fi cal decentralization since many people conceptualized fiscal decentralization depending on their culture. Monthly transfer of the public funds for wage and non wage expenditure to the heath centre and regular publication in the main newspapers and radio to avoid misalloc~ tion ofthe funds.