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
ABSTRACT An overwhelming body of literature claims that decentralization in all its forms is an important engine of development. The main motivation for this study was therefore to examine the impact of decentralization on health service delivery in Ruteete Sub County, Kagadi District. The study objectives were; to identify health services delivered in Ruteete Sub County, find out how health users participate in health service delivery and to identify the constraints affecting the delivery of health services to the people in Ruteete Sub County. The study employed a descriptive design in which a sample of 90 respondents was interviewed whereby 45 were males and 45 were females. Both primary and secondary data were collecting materials in this study. The study found that the main health services delivered were; antenatal care, HIV testing and treatment, family planning services, surgical services treatment of accident casualties, blood testing etc. The study further found out that health service users participate in health service delivery through; attending health meetings, engaging in health campaigns, being consulted, collaboration with health workers, sensitization etc. The main constraints affecting health service delivery in Ruteete Sub County were; under funding, corruption, traditional beliefs, ignorance, religious differences, political influence, poor transport and communication network, high population growth rates etc. The study concluded that decentralization has greatly improved on health service delivery in Ruteete Sub County which people say that it has improved on their health standards and life expectancy. The study finally recommended increasing on the funding of health sector, increase on sensitization campaigns and improve on transport and communication.
