In Uganda, just like most low and middle-income countries, most of the health spending is at the local government (subnational) level. To achieve universal health coverage, efforts to increase health spending need to consider the efficiency and effectiveness of health spending at the subnational level.
In this paper, the authors looked at the adequacy and complementarity of national and international financing for subnational health services in Uganda over a three-year period (2015–2018). The findings show that national fiscal transfers for sub-national health care delivery were inequitably distributed between local governments, and that their inadequacy was constraining the ability of local governments to achieve health outputs. The study provides a number of lessons for decentralised financing of health care programmes to move towards equity at the subnational level.
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