1. DECENTRALIZATION IN UGANDA Suzzane McQueen USAID/Uganda

2. DECENTRALIZATION IN UGANDA Decentralization was one of the cornerstones of Museveni’s National Resistance Movement (NRM) Structure of decentralization in Uganda was modeled after the NRM resistance councils established during the insurgency Focus was on raising political consciousness and securing grassroots participation in decision making Little local control of funds or personnel

3. DECENTRALIZATION IN UGANDA con’t By 1991 NRM government recognized that the system was not improving service delivery In 1993 the system was reformed and local governments were given far greater authority and responsibility These reforms were ratified in the 1995 Ugandan Constitution

4. DECENTRALIZATION IN UGANDA con’t Central government’s role is limited to policy formulation, planning, inspection and management of national programs Districts have responsibility for service delivery including: - hiring and firing of staff - mgmt of central government financial transfers

5. Administrative & Health Political Population Chief Administrative Officer District Council & Local Council Five Chairman District 500,000 Director District Health Services District Mgmt Team LC IVillage 1000 Health Sub District HC IV HC III HC II HC I Parish 5,000 Sub-County 20,000 LC III County 100,000 Family and Individuals LCII LCIV

6. FISCAL DECENTRALIZATION Districts receive resources from: local taxes; donor project support; general tax revenue; donor funding; and debt relief funds (PAF) General tax revenues, donor funding and PAF are pooled national into basket fund and allocated to districts as conditional and unconditional grants

7. CHALLENGES AND CONSTRAINTS There are 26 different financial transfer systems and bank accounts Persistently low level of local revenue- raising Poor or no infrastructure available, particularly at the beginning

8. CHALLENGES AND CONSTRAINTS Con’t. Weak district capacity Lack of systems for planning, management, training, and supervision Major staffing gaps and high turnover of qualified personnel.

9. CHALLENGES AND CONSTRAINTS Con’t. Poor communication/distrust between political and technical leaders Weak management of payroll and personnel contributing to low staff morale and absenteeism

10. IMPACT OF DECENTRALIZATION Poor quality of services Staff attitude Drug stock outs Underutilization of services Decline/stagnation of key health indicators Immunization rates Deliveries assisted by trained staff Infant Mortality Rate Total Fertility Rate

11. POSITIVE DEVELOPMENTS & OPPORTUNITIES Reforming the system to have only three different financial transfer systems Districts will have more leeway to allocate resources across sectors within these transfers Clear government commitment to improving local tax revenue

12. POSITIVE DEVELOPMENTS & OPPORTUNITIES Con’t. Improved infrastructure Poverty Alleviation Funds (PAF) have increased available resources for districts

13. USAID AND DISH II CONTRIBUTIONS Built capacity of district personnel to manage and plan Minimized disruption of service delivery through innovative training systems

14. USAID AND DISH II CONTRIBUTIONS Con’t. Fostered use of information for advocacy and decision making Developed new bilaterals to build upon DISH II successes

15. TAKE HOME MESSAGE Decentralization is happening regardless of whether or not we think it is a good thing Where there is strong leadership districts can flourish under decentralization With a flexible system most problems can be addressed