Abstract

Results Based Finance (RBF) has become an essential tool in bridging the financing gap that countries like Uganda face in providing Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCAH) services. Kasese district in Uganda has a high need for RMNCAH services given the structure of its population. An estimated 55% of the people in Kasese are children below the age of 18 years. In addition, 20% of the people is Kasese are women of reproductive age (15 – 49 years). However, the district has a high rate of maternal deaths with some of sub-counties having maternal death rates that are above the national average. These challenges have persisted in spite of the RBF efforts to improve health service provision in the district.

Conclusion

Finally, among the structural challenges noted was the limited nature of participation of CSOs in the implementation of the RBF projects in Kasese. It was noted that there was no platform such as the expanded District Health Management Team to ensure a designated space for CSOs to participate. Against such conclusions, this paper recommends the following:

  • Enable in collaboration with MoH should consider incorporating an Expanded District Health Team structure in the implementation design of the Establishing a Financial Mechanism for Strategic Purchasing of Health Services in Uganda (SPHU) project. This is especially important because the project is still in its nascent stages and is in place until July 2021.
  • There is therefore a need for CSO and communities to monitoring the implementation of the RBF project especially in order for the reported RBF results to be verified. Scorecards can be adopted as of the methods to be used for the monitoring.
  • In line with CSO participation, there is a need for the formulation of the Expanded District Health Management Team as per the guidelines of the National RBF Framework with representation of CSOs.
  • There is also need for CSO collaboration platform on RMNCAH which should bring together the national and subnational CSOs. This will ensure that the evidence generated from the subnational work on RMNCAH finds its way in policy discussions at the national level where most of the decision makers are located.
  • It is essential that all RBF projects around the country are switched to the RBF digitalised system in order to limit the delays in disbursement of funds.
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