Department of Health Sciences of Uganda Martyrs University
Abstract
Hospital Autonomy, a sustained and purposeful change to improve the
efficiency, equity and effectiveness of the health sector has been
initiated to improve publicly-owned hospitals which, in many developing
countries, consume large portions of scarce health sector resources and
do not always use them effectively and efficiently. While the general
consensus seems to be that public hospitals are in need of urgent
reform, autonomy seems to be emerging in international debates as the
main approach to be followed. Its central idea is the decentralization
of management authority and responsibility away from the central or
regional managers to a local level, focusing mainly on five main
administrative and functional areas: Strategic/General Management,
Financial Management, Human Resource Management, Procurement and
Administration. In Uganda, the Ministry of Health (MOH) granted the two
National Referral Hospitals, Mulago and Butabika, a very limited "self
accounting" status of autonomy, with a view to extend greater autonomy
to these two and ten other regional referral hospitals by 2003. The
focus of this study was to assess the extent of implementation of the
autonomy by the two that had been autonomous for over ten years