ABSTRACT

The study set out to establish the effect of decentralization and performance of local government in social service delivery in kagadi district. The study was to assess the contributions of decentralization in promoting health service delivery in Kagadi district, to explore the challenges encountered in implementing decentralization of health service delivery and explores measures for improving decentralization and, hence promotes efficient health service delivery in Kagadi district. The study was conducted based on descriptive research design, the study was based on the local leaders (politicians), civil servants at the district and health personnel in 3 government health centers of Kagadi district, these were 60 respondents. Data was collected using the closed ended questionnaires. The data collected was analyzed based on frequency and percentages. The ludy findings indicate that decentralization has low contribution to health service delivery, regarding the challenges to decentralization; the study established that funding, poor policy and administration constraints limit decentralization. The study found out that measures of funding, policy, administration are important enabling the local government function well. The study concludes that decentralization contributed to health services delivery, the contribution to thehealth services is low, and the mode of provision is quite low, hence, the need for more focus on the study. The study further concluded that decentralization for health service delivery is limited by policy, funding and regulatory issues that affect the provision and establishment of the means :~f work for the health service delivery in the country. The study concluded that the measures for improving decentralization and, hence, promote efficient health service delivery in Kagadi district there is need for determining a level of mechanisms through diversification, improved finding and necessary adjustments in policy that can determine the efficiency ofthe health sector in the environment of Kagadi district. The study recommended that decentralization system of governance seems to be working well and is a conect avenue for service extension an aspect of development for the people as seen from the respondents of Kagadi district council, therefore it should be strengthened, central government, the district officials should give all the necessary nelp to enable its operation with less inconveniences. The study further recommended for all the stakeholders involvement such as central government in giving advice for effective sensitization and prevention of corruption that is seen as a key impediment to development of local governments. Finally, the government should strengthen service delivery and improve social service accessibility even with direct provisions from central government.

TABLE OF CONTENTS

DECLARATION .1

APPROVAL

DEDICATION iii

ACKNOWLEDGEMENT iv

TABLE OF CONTENTS v

ABSTRACT viii

CHAPTER ONE 1

INTRODUCTION 1

1 .0 Introduction 1

1.1 Background ofthe Study 1

1.2 Statement ofthe Problem 4

1.3 Purpose of the Study 4

1.4 Specific objectives 4.

1 .5 Research Questions 5

1.6 Scope ofthe study 5

1.6.1 Time scope S

1.6.2 Geographical scope 5

1.6.3 Subject scope 5

1.7 Significance ofthe study 5

CHAPTER TWO 6

REVIEW OF LITERATURE 6

2.0 Introduction 6

2.1 Theoretical Review 6

2.2 Conceptual framework 7

2.3 Decentralization and social service delivery . 8

2.3.1 Concept of decentralization 8

2.3.2 Concept of Health service delivery 9

2.3.3 Contribution of decentralization on health service delivery 9

2.4 Challenges encountered in implementing decentralization for social service delivery 14

2.5 Measures for improving the fiscal decentralization for social service delivery 16

V

CHAPTER THREE .20

METHODOLOGY 20

3.0 Introduction 20

3.1 Research design 20

3.2. Study Population 20

3.3.1 Sample Size 20

3.3.2 Sampling Techniques 21

3.4 Sources of data 21

3.4.1 Primary data 21

3.4.2 Secondary data 21

3.5 Data Collection Instruments 22

3.5.1 Questionnaire 22

3.6 Data collection Procedure 22

3.7 Ethical considerations 22

3.8 Data Analysis 23

3.7 Limitations ofthe study 23

CHAPTER FOUR 24

DATA PRESENTATION, INTERPRETATION AND ANALYSIS OF FINDINGS 24

4.0 Introduction 24

4.1 Profile of respondents 24

4.1.1 Findings on the gender ofrespondents 24

Table 1: Showing Gender respondents 24

4.1.2 Findings on Age distribution of respondents 25

Table 2: Show the age distribution ofrespondents 25

4.1.3 Findings on education level of respondents 25

Table 3: Show education level ofthe respondents 25

4.1.4 Marital Status of respondents 26

Table 4: Showing Responses on Marital Status 26

4.2.1 Whether decentralization contribute to health service delivery in Kagadi district 27

4.2.2 Contributions of decentralization towards health service delivery in Kagadi district 28

vi

4.3 Challenges encountered in implementing decentralization for health service delivery in Kagadi district 30

4.3 Whether there are challenges that you encounter in the pursuit of your activities in Kagadi district 30

4.3.2 Challenges encountered in implementing decentralization for health service delivery... 31

4.4 Measures for improving decentralization in health service delivery in Kagadi district 33

4.4 .2 Whether there are measures established to improve decentralization for health service delivery in Kagadi district 33

4.4.2 Measures need to be established to improve decentralization for service delivery in Kagadi district 34

CHAPTER FIVE 36

SUMMARY, DISCUSSION, CONCLUSION AND RECOMMENDATIONS 36

5.0 Introduction 36

5.1 Summary ofthe findings 36

5.2 Discussion ofthe findings 37

5.3 Conclusions 39

5.4 Recommendations 39

5.4 Areas of further research 40

REFERENCES 41

Appendix I: Research Questionnaire 45

Appendix ii: Time frame for the study 49

~ppendix iii: Research Budget 50