DECENTRALIZATION IN UGANDA

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DECENTRALIZATION IN UGANDA

• Suzzane McQueen
• USAID/Uganda

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DECENTRALIZATION IN UGANDA

• Decentralization was one of the cornerstones of
  Musevenis National Resistance Movement (NRM)
• Structure of decentralization in Uganda was
  modeled after the NRM resistance councils
  established during the insurgency
• Focus was on raising political consciousness and
  securing grassroots participation in decision
  making
• Little local control of funds or personnel

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DECENTRALIZATION IN UGANDA cont

• By 1991 NRM government recognized that the system
  was not improving service delivery
• In 1993 the system was reformed and local
  governments were given far greater authority and
  responsibility
• These reforms were ratified in the 1995 Ugandan
  Constitution

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DECENTRALIZATION IN UGANDA cont

• Central governments role is limited to policy
  formulation, planning, inspection and management
  of national programs
• Districts have responsibility for service
  delivery including
• - hiring and firing of staff
• - mgmt of central government financial
• transfers

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Health Sub District HC IV
County 100,000
LCIV
HC III
Sub-County 20,000
LC III
HC II
LCII
Parish 5,000
HC I
Family and Individuals
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FISCAL DECENTRALIZATION

• Districts receive resources from local taxes
  donor project support general tax revenue donor
  funding and debt relief funds (PAF)
• General tax revenues, donor funding and PAF are
  pooled national into basket fund and allocated to
  districts as conditional and unconditional grants

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CHALLENGES AND CONSTRAINTS

• There are 26 different financial transfer systems
  and bank accounts
• Persistently low level of local revenue-raising
• Poor or no infrastructure available, particularly
  at the beginning

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CHALLENGES AND CONSTRAINTS Cont.

• Weak district capacity
• Lack of systems for planning, management,
  training, and supervision
• Major staffing gaps and high turnover of
  qualified personnel.

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CHALLENGES AND CONSTRAINTS Cont.

• Poor communication/distrust between political and
  technical leaders
• Weak management of payroll and personnel
  contributing to low staff morale and absenteeism

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IMPACT OF DECENTRALIZATION

• Poor quality of services
• Staff attitude
• Drug stock outs
• Underutilization of services
• Decline/stagnation of key health indicators
• Immunization rates
• Deliveries assisted by trained staff
• Infant Mortality Rate
• Total Fertility Rate

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POSITIVE DEVELOPMENTS OPPORTUNITIES

• Reforming the system to have only three different
  financial transfer systems
• Districts will have more leeway to allocate
  resources across sectors within these transfers
• Clear government commitment to improving local
  tax revenue

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POSITIVE DEVELOPMENTS OPPORTUNITIES Cont.

• Improved infrastructure
• Poverty Alleviation Funds (PAF) have increased
  available resources for districts

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USAID AND DISH II CONTRIBUTIONS

• Built capacity of district personnel to manage
  and plan
• Minimized disruption of service delivery through
  innovative training systems

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USAID AND DISH II CONTRIBUTIONS Cont.

• Fostered use of information for advocacy and
  decision making
• Developed new bilaterals to build upon DISH II
  successes

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TAKE HOME MESSAGE

• Decentralization is happening regardless of
  whether or not we think it is a good thing
• Where there is strong leadership districts can
  flourish under decentralization
• With a flexible system most problems can be
  addressed