Influence of monitoring & control on health service delivery in Rukungiri District Local Government. A cross-sectional study.
DOI:
https://doi.org/10.70572/agp.v3i7.133Keywords:
Monitoring and control, health service delivery, decentralized governance, public financial management, Rukungiri DistrictAbstract
Background:
Effective monitoring and control systems are essential for ensuring accountability, transparency, and efficient utilization of public resources in decentralized health systems. This study examined the influence of monitoring and control on health service delivery in Rukungiri District Local Government.
Methodology:
A cross-sectional and correlational research design using a mixed-methods approach was employed. Data were collected from 155 sampled respondents drawn from a population of 260, including health workers, DHMT members, finance officers, internal auditors, political leaders, and service beneficiaries. Quantitative data were collected using structured questionnaires, while qualitative data were obtained through interviews and document review. Data were analyzed using SPSS.
Results:
Most of the respondents 30.0% were aged 26–35 years. Monitoring and control systems in the district are generally weak, with low effectiveness in internal audits, expenditure tracking, and supervision. Respondents reported irregular audits, delayed reporting, inadequate staffing, and political interference. However, correlation analysis showed a strong positive relationship between monitoring and control and health service delivery (r = 0.684, p < 0.01). Regression results indicated that monitoring and control significantly predict health service delivery (β = 0.321, p < 0.001), explaining 61.2% of the variation in service delivery outcomes.
Conclusion:
The study indicates that weak monitoring and control systems significantly contribute to poor health service delivery in Rukungiri District Local Government, although strengthening these systems would substantially improve performance.
Recommendation:
The district should also enforce the timely implementation of audit recommendations to improve accountability and reduce inefficiencies.
References
Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approach (5th ed.). SAGE Publications.
International Monetary Fund (IMF). (2023). Fiscal transparency and public financial management in developing countries. IMF Publications.
Ministry of Finance, Planning and Economic Development (MoFPED). (2023). Local government finance management and accountability guidelines. Government of Uganda.
Ministry of Finance, Planning and Economic Development (MoFPED). (2024). Annual report on public financial management performance in Uganda. Government of Uganda.
Ministry of Health, Uganda. (2023). Health sector performance report. Government of Uganda.
OECD. (2021). Public governance and accountability in health systems. OECD Publishing.
Rukungiri District Local Government (RDLG). (2023). Annual health sector performance report. Rukungiri District Local Government.
Rukungiri District Local Government (RDLG). (2024). Internal audit and financial management report. Rukungiri District Local Government.
Rukungiri District Health Office. (2025). District health management and service delivery report. Rukungiri District Health Office.
Saunders, M., Lewis, P., & Thornhill, A. (2019). Research methods for business students (8th ed.). Pearson Education.
World Bank. (2022). Strengthening public financial management systems for improved service delivery. World Bank Publications.
World Health Organization (WHO). (2023). Health systems governance and service delivery in decentralized settings. WHO Press.
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Copyright (c) 2026 Clara Aheebwa, Dr. Muhamad Ssendagi
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