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Budget allocation and community participation in Uganda’s health sector

Health sector is one of the core yardsticks upon which progress and advancement are realized in a particular country and the state, at which a country’s health sector is ranked, usually indicates the overall growth and development in the country.

Uganda is one of the third world countries that set the 15% target in the Abuja Declaration which our own president Yoweri Kaguta Museveni participated to in April 2001.The question stands is the 15% really allocated to the health sector just like the government promised to? The answer to this is very clear which is NO and because of that a lot of challenges in the health sector for the marginalized groups like women and children are still stumpy and that is why we have 17 women who die every day in Uganda due to maternal mortality, 20 women are caught up in maternal complications every day and we have over 570 youths who are infected with HIV everyday in Uganda.

Uganda’s budgetary allocation towards the health sector has been unpredictable for the past four financial years and whereas health activists have, for long, been advocating for a continuous increase of 15% in the health sector budget, it has been fruitless.

In the financial year 2013/14, the health sector received sh940b, up from sh852b in 2012/13. This meant that the sector received about 7.2% of the national budget of sh13.1 trillion, which is still below the 15% target. Last year, the health sector got about 7.6%, while in 2011/12, it got slightly over 8%.In 2010/11, the allocation to health was sh660b and it leaped to sh985.58b in the subsequent year of 2011/12. However, the drop by sh133.58b in the following year 2012/13 to sh852b left many civil society health activists disgruntled.

Just in this year of 2015, CEHURD carried out a dialogue meeting in Buikwe district with an aim of achieving a meaningful documentation on how the community participates in the budget system at the district.

Different stakeholders participated in this dialogue and some of them like the religious leaders and LC 1s where totally uninformed about the whole process. As to the usual community persons, they did not even want to know about the process because to them, even if their ideas were shared, they were never reflected but rather the ideas of the minority group that participates in the budget committee were the ones forwarded at the national level.

This gap comes with a huge challenge and because of lack of participation by the community at the district level, people who are mostly faced with health difficulties will never get redress but rather inconsistent as priority in other areas will be key and health will remain less presented at the national level hence the continuous fall in the allocation of the 15% on health in the country.

The preceding discussion on community participation in the budget process at the community level has shown that it is not a simple process in which the community can easily engage themselves in but one needs to be optimistic about the future of community participation in the process and as a way forward, there is need for novel avenues for community participation which among others may include interactive budget hearings like community dialogues, encourage community participation in budget conferences at the district and also pressure their local leaders like councilors who represent them at the district committee level to priories health while allocating resources in budget.

By Thuraya Mpanga Zawedde

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