ArticleHealth research policy and systems2019
Decision-making in district health planning in Uganda: does use of district-specific evidence matter?
Article in Health research policy and systems, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Child health and the implementation of Community and District-management Empowerment for Scale-up (CODES) in Uganda: a randomised controlled trial.BMJ global health · 2021Trial
- Exploratory mixed-methods analysis of the determinants of use of health research evidence among planning teams in Tanzania.BMJ open · 2025Article
- Maternal health planning and prioritization in Chad: developing a supportive tool.Health policy and planning · 2025Article
- Article
- Analysis of the determinants for using health research evidence in health planning in Tanzania: a cross-sectional study.PloS one · 2025Article
- Assessing the integration of refugee health data into national health information systems in Jordan, Lebanon, and Uganda.Conflict and health · 2024Article
- Article
- A comparative analysis of COVID-19 physical distancing policies in South Africa and Uganda.PLOS global public health · 2024Article
- Challenges for research uptake for health policymaking and practice in low- and middle-income countries: a scoping review.Health research policy and systems · 2023Article
- How does power shape district health management team responsiveness to public feedback in low- and middle-income countries: an interpretive synthesis.Health policy and planning · 2023Article
- Management of human resources for health in health districts in Uganda: A decision space analysis.The International journal of health planning and management · 2022Article
- Transitioning health workers from PEPFAR contracts to the Uganda government payroll.Health policy and planning · 2021Article
- Applying the Community Health Worker Coverage and Capacity Tool for Time-Use Modeling for Program Planning in Rwanda and Zanzibar.Global health, science and practice · 2021Article
- Institutionalization of Projects Into Districts in Low- and Middle-Income Countries Needs Stewardship, Autonomy, and Resources.Global health, science and practice · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundIn a decentralised health system, district health managers are tasked with planning for health service delivery, which should be evidence based. However, planning in low-income countries such as Uganda has been described as ad hoc. A systematic approach to the planning process using district-specific evidence was introduced to district health managers in Uganda. However, little is known about how the use of district-specific evidence informs the planning process. In this study, we investigate how the use of this evidence affects decision-making in the planning process and how stakeholders in the planning process perceived the use of evidence.
methodsA convergent parallel mixed-methods study design was used, where quantitative data was collected from district health annual work plans for the financial years 2012/2013, 2013/2014, 2014/2015 and 2015/2016 as well as from bottleneck analysis reports for 2012, 2013, 2014 and 2015. Qualitative data was collected through semi-structured interviews with key informants from the two study districts.
resultsDistrict managers reported that they were able to produce more robust district annual work plans when they used the systematic approach of using district-specific evidence. Approximately half of the prioritised activities in the annual work plans were evidence based. Procurement and logistics, training, and support supervision activities were the most prioritised activities. Between 4% and 5.5% of the total planned expenditure was for child survival, of which 47% to 94% was from donor and other partner contributions.
conclusionDistrict-specific evidence and a structured process for its use to prioritise activities and make decisions in the planning process at the district level helped systematise the planning process. However, the reported limited decision and fiscal space, inadequate funding and high dependency on donor funding did not always allow for the use of district-specific evidence in the planning process.
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