Result based financing and health service delivery in Uganda: a case study of public health facilities in Bulambuli District

Abstract

The availability of EMHS in low-and middle-income countries is influenced by a variety of complex, underlying factors such as inadequate financing, regulatory issues, lengthy procurement procedures, poor logistics, and weak facility management systems (Sieleunou et al., 2019). Therefore, the purpose of this study was to assess how Result Based Financing affects the availability of Essential Medicine and Health Supplies in public health facilities in remote local government in Uganda, with a case study of public health facilities in Bulambuli District Local Government. This academic research study employed a cross sectional survey design that enabled the researcher gain in-depth information on Result-Based financing and health service delivery in Uganda. The findings of this study revealed that some RBF factors like funding in time had a moderate significant relationship with the quality of service delivery in Public Health facilities (r=0.540, sig=0.001). In addition, funding in time was found to have a 20.1% contribution on the quality of service delivery in Public Health Facilities in Bulambuli District. Furthermore, results also revealed that there is a weak positive correlation and significant relationship between the size of funding and the quality of service delivery in Public Health Facilities (r=0.420, sig=0.015). The size of the funding brings about 12.1% contributions on the quality of service delivery in Public health facilities in Bulambuli District. Performance based incentives had a very strong positive correlation and significant relationship with the quality of service delivery in Public Health facilities (r=0.850, sig=0.009). The results bring a controversial at regression where it shows that performance based incentives brings a reduction on the quality of service delivery in Public Health facilities. Also result shows that Donor influence had a relationship with the quality of service delivery. The study recommends that RBF programme should increase the size of the funds given to the Health facilities. The RBF Programme managers should send or provide funds to the health facilities in time for smooth running of activities regarding buying medicines and other medical equipment used during treatment of mothers and children. Lastly the study recommends that there should be regular monitoring of all activities supported by RBF programme in the Public Health facilities to ensure accountability and transparency of the funds given.