Performance accountability, evaluation of performance by health care providers in Bugisu region

Abstract

There have been hostile press reports and comments from prominent political leaders about the poor and unethical performance of health service providers and the system as a whole. This prompted this study that set out to establish whether the health providers measured their performance, and whether they accounted to the stakeholders, whether the stakeholders took remedial action and if all that was done then what factors were influencing performance accountability that it was not delivering the desired result. The study took place in three districts of Bugisu region, purposively sampled and these were Bududa, Bulambuli and Mbale. Each district was divided into geographical zones. From each zone a health centre (HC) II and a HC III were sampled randomly using table of random numbers. The district Local Council V (LC V) chairmen, secretary health and chairperson health committee were interviewed using a prepared questionnaire, The same questionnaire was administered to the Chief Administrative Officers (CAO), District Health Officers (DHO) and Assistant district health officers (ADHO). For every randomly selected facility the corresponding Local Council (LC) III chairman, secretary health and chairperson health committee were also interviewed. The same questionnaire was administered to the facility in charge. A different questionnaire was administered to two Health Unit management committee (HUMC) members that were not health workers. A check list was also filled for each sampled facility. General hospitals and Health centre IV were purposively sampled and a questionnaire administered to the in charge and senior nursing officer, a check list was also administered. The findings showed that there was performance accountability provided to stakeholders by the service providers and the stakeholders read and understood the accountable and took action to remedy the situation. However it was also established the failures arose because of inadequate funding and inequitable resource allocation from the centre.