Budget preparation and the quality of service delivery in health facilities

Abstract

This study examines the effect of budget preparation on the quality of service delivery in public health facilities in Kasese District, Uganda. Budget preparation is conceptualised as a participatory planning process, while service delivery is assessed across dimensions of tangibility, reliability, responsiveness, assurance, and empathy. A cross-sectional design employing both quantitative and qualitative approaches was used, with data collected from 336 Participants. Findings reveal a weak and statistically insignificant relationship between budget preparation and service delivery (r = -0.176, p > 0.05). Qualitative findings suggest that although budget preparation structures exist, they are often characterised by limited stakeholder participation, weak responsiveness to local needs, and centralised decision-making processes. The study concludes that budget preparation alone does not significantly influence service delivery outcomes in public health facilities. It recommends strengthening participatory and evidence-based budgeting practices to enhance alignment between planning processes and service delivery priorities. The study contributes to ongoing discussions on public financial management and health system performance in decentralised settings