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.