Research for stronger health systems during and after crisis

Exploring the link between Governance and Aid Effectiveness in Strengthening Post-Conflict Health Systems in Uganda

About US$ 1.3 billion have been pledged towards health system reconstruction in Northern Uganda by a multitude of both state and non-state actors. Governance in Uganda was decentralized to local governments in 1997 and so power was dissolved to local government units such as District Councils, Municipalities and other lower administrative units. However, the prolonged period of conflict affected the capacity of the local governments in northern Uganda to perform expected functions such as coordination of many actors in the post conflict period. The implications of this include unproductive duplication and dysfunctional relationships among the health system actors and eventually sub-optimal effectiveness of health responses. Hence, capacity development of legitimate institutions becomes a priority in the process of rebuilding health systems.

This ReBUILD research project sought to generate information about the relationships across different agencies implementing three selected health programmes in northern Uganda. These include; maternal service delivery, HIV treatment services and workforce support. The research in this field will also enable us to assess the inter-agency relationships across districts for the implementation of the selected health programs using social network analysis. In addition, the study aims to provide an analysis of the major dynamics in aid-relationships and aid-effectiveness within the district-level network of health-related agencies.

Given that the research has two phases, findings from phase 2 data collection will enable us to have a comparison of how the network relationship between implementing agencies of the selected services could have changed over a period of 2-3 years.

It is hoped that this information will contribute to building district capacity to coordinate these agencies better and ensure optimum effectiveness of aid programmes in the post-conflict region of northern Uganda.