Infant mortality rates and decentralisation in Uganda

Background

Many countries in the developing world have embarked on the path of decentralisation over the last three decades to improve the provision of public goods such as healthcare services. It is hypothesised that devolving power to local governments would improve efficiency as well as equity and thereby health outcomes by bringing decision makers closer to the people, and by enhancing the participation of the community in the decision-making and implementation processes.

Aims

This paper aims to assess the impact of decentralisation on infant mortality rates in Uganda.

Methods

The intervention model was used to analyse national representative data from Uganda Demographic Health Surveys (1988/89, 1995, 2001, 2006).

Results

Results indicate that infant mortality rates deteriorated during the decentralisation period in three out of four regions in Uganda, but not overall when analysed for the whole country.

Conclusion

Decentralisation was supposed to lead to a decrease in infant mortality rates, however, the opposite effect was seen with rates increasing in individual regions. There is need for further detailed studies to understand why infant mortality rates increased during the period of decentralisation in Uganda.