The curse of league tables: how Uganda missed the point

Abstract

This paper examines the criteria used by the Ministry of Health to determine the performance of the different districts as presented in the annual National Health Sector Performance Report. Using the winner of the 2004/2005, it attempts to analyze the health situation in the district and challenges the reliability of using HSSP input, process and output indicators as a measure of sector performance. The paper proposes that outcome indicators, like health status indicators, are a better measure of sector performance and should be the ones used for rating district performance. It also suggests that process indicators be used for technical forums and not political forums like the National Health Assembly. It ends with a cautionary remark on the likely misinterpretation of process indicators by the general public in districts with poor health status.