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Health versus other sectors: Multisectoral resource allocation preferences in Mukono district, Uganda

OBJECTIVES: To elicit citizen preferences for national budget resource allocation in Uganda, examine respondents’ preferences for health vis-à-vis other sectors, and compare these preferences with actual government budget allocations. METHODS: We surveyed 432 households in urban and rural areas of M...

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Autores principales: Yemeke, Tatenda T., Kiracho, Elizabeth E., Mutebi, Aloysius, Apolot, Rebecca R., Ssebagereka, Anthony, Evans, Daniel R., Ozawa, Sachiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392331/
https://www.ncbi.nlm.nih.gov/pubmed/32730256
http://dx.doi.org/10.1371/journal.pone.0235250
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author Yemeke, Tatenda T.
Kiracho, Elizabeth E.
Mutebi, Aloysius
Apolot, Rebecca R.
Ssebagereka, Anthony
Evans, Daniel R.
Ozawa, Sachiko
author_facet Yemeke, Tatenda T.
Kiracho, Elizabeth E.
Mutebi, Aloysius
Apolot, Rebecca R.
Ssebagereka, Anthony
Evans, Daniel R.
Ozawa, Sachiko
author_sort Yemeke, Tatenda T.
collection PubMed
description OBJECTIVES: To elicit citizen preferences for national budget resource allocation in Uganda, examine respondents’ preferences for health vis-à-vis other sectors, and compare these preferences with actual government budget allocations. METHODS: We surveyed 432 households in urban and rural areas of Mukono district in central Uganda.We elicited citizens’ preferences for resource allocation across all sectors using a best-worst scaling (BWS) survey. The BWS survey consisted of 16 sectors corresponding to the Uganda national budget line items. Respondents chose, from a subset of four sectors across 16 choice tasks, which sectors they thought were most and least important to allocate resources to. We utilized the relative best-minus-worst score method and a conditional logistic regression to obtain ranked preferences for resource allocation across sectors. We then compared the respondents’ preferences with actual government budget allocations. RESULTS: The health sector was the top ranked sector where 82% of respondents selected health as the most important sector for the government to fund, but it was ranked sixth in national budget allocation, encompassing 6.4% of the total budget. Beyond health, water and environment, agriculture, and social development sectors were largely underfunded compared to respondents’ preferences. Works and transport, education, security, and justice, law and order received a larger share of the national budget compared to respondents’ preferences. CONCLUSIONS: Among respondents from Mukono district in Uganda, we found that citizens’ preferences for resource allocation across sectors, including for the health sector, were fundamentally misaligned with current government budget allocations. Evidence of respondents’ strong preferences for allocating resources to the health sector could help stakeholders make the case for increased health sector allocations. Greater investment in health is not only essential to satisfy citizens’ needs and preferences, but also to meet the government’s health goals to improve health, strengthen health systems, and achieve universal health coverage.
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spelling pubmed-73923312020-08-14 Health versus other sectors: Multisectoral resource allocation preferences in Mukono district, Uganda Yemeke, Tatenda T. Kiracho, Elizabeth E. Mutebi, Aloysius Apolot, Rebecca R. Ssebagereka, Anthony Evans, Daniel R. Ozawa, Sachiko PLoS One Research Article OBJECTIVES: To elicit citizen preferences for national budget resource allocation in Uganda, examine respondents’ preferences for health vis-à-vis other sectors, and compare these preferences with actual government budget allocations. METHODS: We surveyed 432 households in urban and rural areas of Mukono district in central Uganda.We elicited citizens’ preferences for resource allocation across all sectors using a best-worst scaling (BWS) survey. The BWS survey consisted of 16 sectors corresponding to the Uganda national budget line items. Respondents chose, from a subset of four sectors across 16 choice tasks, which sectors they thought were most and least important to allocate resources to. We utilized the relative best-minus-worst score method and a conditional logistic regression to obtain ranked preferences for resource allocation across sectors. We then compared the respondents’ preferences with actual government budget allocations. RESULTS: The health sector was the top ranked sector where 82% of respondents selected health as the most important sector for the government to fund, but it was ranked sixth in national budget allocation, encompassing 6.4% of the total budget. Beyond health, water and environment, agriculture, and social development sectors were largely underfunded compared to respondents’ preferences. Works and transport, education, security, and justice, law and order received a larger share of the national budget compared to respondents’ preferences. CONCLUSIONS: Among respondents from Mukono district in Uganda, we found that citizens’ preferences for resource allocation across sectors, including for the health sector, were fundamentally misaligned with current government budget allocations. Evidence of respondents’ strong preferences for allocating resources to the health sector could help stakeholders make the case for increased health sector allocations. Greater investment in health is not only essential to satisfy citizens’ needs and preferences, but also to meet the government’s health goals to improve health, strengthen health systems, and achieve universal health coverage. Public Library of Science 2020-07-30 /pmc/articles/PMC7392331/ /pubmed/32730256 http://dx.doi.org/10.1371/journal.pone.0235250 Text en © 2020 Yemeke et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Yemeke, Tatenda T.
Kiracho, Elizabeth E.
Mutebi, Aloysius
Apolot, Rebecca R.
Ssebagereka, Anthony
Evans, Daniel R.
Ozawa, Sachiko
Health versus other sectors: Multisectoral resource allocation preferences in Mukono district, Uganda
title Health versus other sectors: Multisectoral resource allocation preferences in Mukono district, Uganda
title_full Health versus other sectors: Multisectoral resource allocation preferences in Mukono district, Uganda
title_fullStr Health versus other sectors: Multisectoral resource allocation preferences in Mukono district, Uganda
title_full_unstemmed Health versus other sectors: Multisectoral resource allocation preferences in Mukono district, Uganda
title_short Health versus other sectors: Multisectoral resource allocation preferences in Mukono district, Uganda
title_sort health versus other sectors: multisectoral resource allocation preferences in mukono district, uganda
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392331/
https://www.ncbi.nlm.nih.gov/pubmed/32730256
http://dx.doi.org/10.1371/journal.pone.0235250
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