An Examination of the Effect of Reward Management System in Health Service Delivery in Local Governments in Uganda: A Case Study of Apac District Health Services.

Abstract

MARLEY BEN LAWRENCE (2008-M092-20069) An Examination of the Effect of Reward Management System in Health Service Delivery in Local Governments in Uganda: A Case Study of Apac District Health Services. World over, there is a growing global health workforce crisis. Africa and other developing countries have suffered from brain drain of its professional health workers. In Uganda, government implemented a comprehensive reform of the health sector and incentive schemes with a view to retain her health workforce in order to improve efficiency and effectiveness through improved access to basic health care services. In spite of the reforms, there is a growing concern over the quality and quantity of health services in Apac district. The study, therefore, examined the effect of reward management in health departments and health service delivery in Apac district. The independent variables were financial rewards and non-financial reward and the dependent variable was Uganda Minimum Health Care Package. The specific objectives were: to find out whether basic pay affects health service delivery in Apac district; to assess whether lunch and health allowances affect Health Service delivery in Apac district; to find out if promotions, equipments, medicine and accommodation affect health service delivery in Apac district. The study used both quantitative and qualitative research approaches and descriptive design. The techniques were used because the researcher felt it would capture the views of the respondents much more adequately. The target population was 183 from which a sample of 122 was derived; however, 111 questionnaires (91%) were received. The population composed of Doctors and Dentists, Nursing Officers, Clinical Officers, Enrolled Midwives, Enrolled Nurses and Nursing Assistants. These categories were thought to be directly involved in the provision of health services to the public in Apac district. The major findings from the study are not limited but include the following: 97.3% of health workers were on the payroll and allowances were not commensurate with their workload. Equipment was inadequate and constant stock-out of drugs, promotion is not based on merit, and technocrats rarely monitor health facilities. The following recommendations were made: the basic pay should be made competitive according to market rates, risk allowance should be paid and a monitoring fund should be created. The Health Management Committee should be strengthened and a community information mechanism to elicit feedback should be introduced. The researcher believes that the recommendations above will improve health service delivery in Apac district. Key Words: Reward Management System, Health Service Delivery, Local Governments, Apac District Health Services.