Fraud and Service Delivery in Uganda's Health Sector :

Abstract

This research was carried out at selected Health centres in Wakiso District. The researcher examined “Fraud and its implications on Service delivery in Uganda’s Health Sector.” The objective of the research was to establish challenges faced during fraud management and its implications on health sector in wakiso district. Methodology: A cross sectional study was done while using random sampling and purposive sampling for patients and key informants corresponding. The tools used were research administered questionnaires and key informant interviews. Data that was collected was edited, entered into excel software and then analyzed using SPSS. Results: The actual causes of fraud were found to be inadequate drugs and lack of close supervision, i.e. (CI=0.27-28.39, OR=2.77, p-valve=0.001) and (CI=0.2-16.23, OR=1.38, p-valve=0.032) correspondingly. The challenges that are found to have a strong relationship with fraud were; political interference and (CI=0.05-4.58, OR=0.5, p-valve=0.040) and lack of professionalism (CI=0.04-1.70, OR=0.27, p-valve=0.002). However, the government has faced a number of challenges in managing fraud. Some of the challenge included the following among others, lack of transparence in implementation of policies in health sector, inadequate funds, political interference, lack of enough sensitization to workers and the public and inadequate skills. The research has also found the government has put on some measures which have been used to manage fraud. These include, increasing staff salaries, sensitizing the health workers and the public about the dangers of fraud and employing health workers who have enough skills in provision of health services. Recommendations: The study recommends that the corrupt officials should be punished through termination of contracts, imprisonment and returning what have been stolen in order to discourage those who would intend to commit fraud; Strong systems should be put in place to monitor and manage fraud within the health sector, health workers should be trained to behave professionally and deliver services to the expectations of the health sector and the general public; The government should increase the remunerations of health workers such that they cannot be tempted to commit fraudulent acts, and there should be transparency in implementation of activities to enable the public also to monitor and participate.