Health Sector Financing and Service Delivery in Government Hospitals in Uganda: A Case Study of Mbale Regional Referral Hospital.

Abstract

OKWERA COLLINS (2014-M102-20025) Health Sector Financing and Service Delivery in Government Hospitals in Uganda: A Case Study of Mbale Regional Referral Hospital. The research was carried out to establish the relationship between health financing and service delivery in government hospitals in Uganda. The research was prompted by the poor performance indicators of health service delivery in Uganda. The objectives of the study were: to examine the relationship between mobilisation of funds and service delivery in Uganda Government Hospitals; to analyse the relationship between allocation of funds and service delivery in Uganda Government Hospitals; and to establish the relationship between accountability of funds and service delivery in Uganda Government Hospitals. The researcher employed case study design, adopting both qualitative and quantitative approaches to data collection. The study population was 98 from which a sample of 91 respondents were selected using stratified random sampling, specifically because the researcher wanted to identify and target various respondents according to their responsibilities in the hospital. The sample size was derived using table for determining sample size by Krejcie and Morgan, (1970) as cited by (Amin, 2005). Data collection was by use of questionnaires and interview guides. This was analysed using the Statistical Package for the Social Sciences (SPSS) and was presented in tables. The research findings revealed a strong positive significant relationship between health financing and service delivery in government hospitals of Uganda of r=0.243. This implies that when health financing is improved, service delivery will also improve. This is in line with WHO (2010), which notes that a well-functioning health care system requires a robust financing mechanism to enable the health facility deliver quality services. The research findings also revealed a positive significant relationship between mobilisation of funds and service delivery in Uganda Government Hospitals with r=0.287, p=0.035. This implies that if funds for health financing are mobilised through the different sources like Government grants, donors, insurance and user fees, service delivery can improve. This is in line with WHO-MBHSS (2010), which noted that health financing can be from government grants, donors, insurance and user fees, which can be used to improve service delivery. The study also revealed a positive significant relationship between allocation of funds and service delivery with r=0.529, p=0.025. This means that if funds are well allocated to the different departments of the hospital, service delivery will improve. This is in line with Ssengooba (2004), who noted that shifting towards a pro-poor allocation approach based on health needs implies a significant break with tradition and improves service delivery. The researcher recommends that funds should be mobilised through Government grants and other donors. This will ensure access to all and not limited by finances. Therefore, Mbale Hospital should advocate for more funding from Government grants and donors. Allocation of funds should be in terms of the size of the hospital, number of beds in the department, size of the population of thearea as this will ensure there is no misuse of funds once allocated and finally, the hospitals should account for the funds on time. Key Words: Health Sector Financing, Service Delivery, Government Hospitals, Mbale Regional Referral Hospital.