Financial priorities under decentralization in Uganda

Abstract

This paper explores changes to budget allocations for health during the decentralization process in Uganda. When the districts were given the authority to allot their own budgets, allocations for health were reduced considerably. The rationale for this by district leaders is investigated and analyzed. Their criteria for budget allocations for health are often based on views different to those held at central level, hence there can be conflict between the two. The mechanisms instituted by central government in reaction to what was perceived as a lack of local support to the health sector are described. In conclusion, while conditional funding may be a useful short-term step, long-term development requires less conditionalities. Health professionals need to work closely with local leaders and district officials to make health a political priority in order to develop and allocate resources for health at local level.