Public expenditure tracking for family planning services in Uganda

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In 2011, FOWODE began examining the extent to which funds for safe motherhood especially Family Planning Services have been utilized and whether there are any leakages in distribution of family planning drugs and materials. While applying the Public Expenditure Tracking Survey (PETS) methodology, FOWODE tracked the flow of family planning funds/commodities from Uganda’s Ministry of Finance, Planning and Economic Development to the Ministry of Health, National Medical Stores (NMS) and to the Health Center IVs and Health Center IIIs in the 5 selected districts.

In total 20 Health Center IIIs and 10 Health Center IVs were randomly but proportionately selected in Luwero, Kabale, Kibaale, Gulu and Kibuku and data was gathered to ascertain the amounts of funds allocated for family planning services. To discover the nature and efficacy of criteria used to allocate, disburse and account for funds released for Family Planning services and also to determine the levels of re-allocations, diversions and leakages (if any) of funds allocated to the different budget lines for family planning services.

The assessment revealed that in relation to the transfer of Funds from the Central Level to the Health Units, Donors contributed much more than what the Central Government contributes, for example for the financial year 2010/11 USD 923,440 was allocated by the Ministry of Finance Planning through the National Medical Stores and USD 9,213,952 was allocated by donors including UNFPA, USAID and DFID.

It was also discovered that whereas Donors procure commodities and contract the National Medical Store to distribute to all health units in the country. Ministry of Finance disburses funds to the national medical stores to purchase, store and distribute family planning materials to all health units in the country.

Funds for promoting consumption of family planning services at lower health unit levels are part of the general PHC non wage grant that is released quarterly to health units.

The flow of family planning commodities is not consistent in some health units for example, Health Centre III's are supplied a standard kit of materials every two months which may not necessarily meet the needs of users in a particular community.

The assessment also observed, laxity in record keeping of family planning and deliveries by National Medical Stores and the health centers making it hard to accurately account for these commodities on monthly, quarterly, bi-annual, annual basis. There was also serious under utilization of family planning services at health centers with condoms being the most used family planning method.

FOWODE intends to engage with government and other key stakeholder to address the key findings of this assessment and to do this systematically an advocacy strategy has been developed to effectively lobby for improved financing and management of reproductive health services in Uganda.

Story by: Carol Namagembe
Programme Officer Communications
FOWODE

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