Agume Kabisyaki ABaluku WatsemaAhabwe Alex2026-11-132026-11-132026-07-06Anthony, A. K.,Watsema,B. & Alex, A. (2026). Budget Preparation and the Quality of Service Delivery in Health Facilities: A Case of Public Health Facilities in Kasese District.International Journal of Finance and Accounting, 5(1), 344-357. https://doi.org/10.37284/ijfa.5.1.5283http://hdl.handle.net/20.500.12280/3342This 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 settingsenhttps://creativecommons.org/licenses/by/4.0/Budget PreparationQuality of Service DeliveryHealthy FacilitiesArticlehttps://doi.org/10.37284/ijfa.5.1.5283