Assessing Public Expenditure Governance in Uganda’s Health Sector: The case of Gulu, Kamuli, and Luweero Districts. Application of an Innovative Framework

"This research report is one of the policy analyses prepared by ACODE to assess the governance of public expenditure (hereafter, public expenditure governance or PEG) in Uganda’s health, road, education and agriculture sectors. The report is premised against the dimensions of governance elaborated in the framework suggested by Baez-Camargo and Jacobs (2011). The report provides the first attempt to model indicators for assessing PEG in Uganda’s health sector, which can also be replicated in other sectors of the economy and other countries. This report specifically presents the assessment of Public Expenditure Governance (PEG) within the health sector and how this affects the performance of the sector. Unlike tools for assessing public financial management which tend to focus specifically on management of funds, the PEG assessment focuses on inputs, processes and outcomes. Inputs are the laws, policies, rules, regulations, goals and priorities that govern actions and decision making. The assessment principles associated with the input side of PEG are participation and strategic vision. The assessment principles focusing on process are accountability and transparency, both of which are essential if processes are to lead to desired outcomes. The desired outcomes of PEG associated with health care are equity, efficiency and effectiveness. Using this PEG conceptual framework, the overall objective of this research was to examine the links between public spending, governance, and outcomes in the health sector."