Uganda

Key research question:

What can be done to improve the performance of public and private ‘not-for-profit’ facilities in meeting the health-related needs of the poor in Uganda?

Members of the Uganda research team

This study aims to improve the ability of the Ugandan health system to provide services that meet the needs of the poor. The main policy questions that the study team aims to answer over the first three years of the study are:

• What mechanisms can help policy makers get better value in terms of access, volume and quality of services for the poor from both private not-for profit providers (PNFP) and public facilities?
• How can users, especially the poor, be empowered to demand quality services?

The first year of the study will consist mainly of formative research. This will lay a foundation for later work. We will carry out an extensive review of published and grey literature on the:

• socioeconomic profile of the users of health services,
• quality of health services and
• mechanisms for empowering the community to demand better services.

Secondary data analysis of the Uganda National Household Surveys and the national service delivery surveys are also being done, looking at patterns of health care utilization and payments for care by vulnerability characteristics and by household socio-economic status in terms of wealth and income. This will assist in providing a better understanding of the type of services that are available to various population groups in Uganda with emphasis on the poor.

In the second year of the study a cross sectional study aimed at assessing the cost, volume, access and quality of services provided by public and private not for profit (PNFP) facilities will be done. The ingredients approach will be used for the costing of specific services using retrospective financial cost data. The study will be done from both the providers’ perspective and the clients’ perspective.

The third year of the study will focus on developing an instrument that can be used to assess the quality of services offered in the public and private health facilities. Thereafter an innovative approach to improve the quality of services offered in the public and the private facilities will be piloted. A mechanism that can be used to empower the community to demand for better services will also be piloted in the third year of the study.

The findings of this research will be expected to contribute to the debate about how services can be provided to meet the needs of the poor. In particular it should contribute towards social protection of the poor, making the private and public health sectors work for the poor and facilitating health policy processes and research to policy linkages and directing them towards meeting the needs of the poor.