Exploring the Implications of District Splitting on the Constitution and Functionality of District Service Commissions in Uganda: A Case Study of 8 Districts in Uganda

Abstract

In Uganda district splitting occurs when new districts are created out of old districts using existing boundaries which usually constitute a health sub district or county boundary. The Ugandan system of local governance is based on the district as a functional unit under which there are lower local governments and administrative units that follow the devolution system of decentralisation. The aim of this study was therefore to assess issues affecting constitution, functionality and operationalization (establishment and appointment) of District Service Commission (DSCs). This was an exploratory crosssectional study that used qualitative methods about the implications of the phenomenon of district splitting (creation) in relation to constitution and functionality of the district service commissions and human resources for health management. We purposively collected data from 16 key informants based on their roles and responsibilities on the DSCs. Out of the eight districts in the study, only one district constituted a fully functional DSC while the remaining seven districts managed to constitute DSCs in a period between 6 and 12 months. This study shows that splitting negatively affected both the parent and child (new) districts in sense that they could not constitute a complete committee within the stipulated time of three months. Generally, all the districts have had challenges in constituting the DSCs of 5-7 commission committee members. Only one in the eight districts had managed to constitute a full committee within three months of post-splitting. After districts are split, majority of the DSCs especially in the child districts took over almost a year to be constituted and fully functional due to mainly lack of qualified members for example retired senior civil servants in these districts. All the eight districts had a challenge of political interference during the process of appointing the technical team, which delayed constitution of quorum of DSCs in the districts. Lack of resources to carry out most of the DSC functions was also mentioned in all districts as a major hindrance to the district councils which were responsible for appointing DSC members. The DSCs should be allowed to operate with no political interference and this can be enacted as a law by parliament.

Management of human resources for health in health districts in Uganda: A decision space analysis

“…The government health service is structured into national, district and sub‐district levels (Figure 1). 22–24 From the 1990s new districts have been created from existing districts 25 —referred to as “district splitting”—which has been quite rapid with the number of districts tripling between 1990 and 2016 26 . The Health Sub District (HSD) acts as a functional subdivision of the district health system, connecting the district office to the lower levels and improving the planning and management of sub‐district health services 27 .…”

“… 22 , 23 , 24 From the 1990s new districts have been created from existing districts 25 —referred to as “district splitting”—which has been quite rapid with the number of districts tripling between 1990 and 2016. 26 The Health Sub District (HSD) acts as a functional subdivision of the district health system, connecting the district office to the lower levels and improving the planning and management of sub‐district health services. 27 Within the health sub‐district there are health centres (II, III and IV) and village health teams.…”