READINESS OF PRIMARY HEALTHCARE FACILITIES TO PROVIDE HEALTH SERVICES IN PALLISA AND MUKONO DISTRICTS: IMPLICATIONS FOR THE NATIONAL RESULTS-BASED FINANCING PROGRAMME IN UGANDA.
Abstract
Background: In Uganda, many healthcare facilities lack the components required to provide
services. In the financial year 2018/2019, the ministry of health institutionalized results-based
financing in the health sector. This study assessed the readiness of primary healthcare
facilities to provide services in Pallisa and Mukono districts and explores the implication that
health facility readiness has on the national results-based financing programme.
Methods: A mixed methods study was carried out in two district of Uganda from April to
May, 2019. All the healthcare facilities that had been that had undergone a readiness
assessment under the ministry of health results-based financing programme in Pallisa district
and Mukono districts between August 2018 and May, 2019, were included in the study. Data
on health facility readiness were extracted from the ministry of health results-based financing
readiness assessment tools. For qualitative data, a total of 16 key informants from the two
districts were interviewed to explore the implication of health facility readiness on the
national results-based financing programme as well as the constraints and opportunities for
improving health facility readiness. Quantitative data were analysed descriptively in STATA
version 14 while non-parametric tests were used to test for differences in the mean readiness
scores between the different districts, types of ownership and health facility levels. Lastly,
qualitative data were analysed using the directed context analysis.
Results: All the facilities that were assessed in the two districts were ready to provide
services (mean score = 81.04%, S.D = 7.21%). Generally, the health facilities performed
fairly in terms of health financing (mean score = 68%). The key informants unanimously
agreed that low health facility readiness has bad implications for the national results-based
financing programme. The lack of resources and inability of health facilities to intervene in
some areas were noted to be the major constraints to health facility readiness. Fortunately, the
key informants noted a number of opportunities that could be exploited to boost health
facility readiness. These included; existing community structures, interns, volunteers and
community health workers
Conclusion: All the health facilities assessed in this study were ready to provide services.
Generally, the facilities performed fairly in terms of health financing and this was likely to
have bad implications for the national RBF programme.