NRU :: Browsing by Author "Kagambirwe Karyeija, Gerald"

Browsing by Author "Kagambirwe Karyeija, Gerald"

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Anti-Malarial Targeting and Dosing Practices among Health Workers at Lower Level Health Facilities in Uganda
(Health, 2014) Kakeeto, Stella; Wanzira, Humphrey; Kagambirwe Karyeija, Gerald; Kamya, Moses; Bukirwa, Hasifa
Health worker shortages remain a significant challenge to delivery of health care services globally. Moving tasks, where appropriate, to less specialized health workers is recommended by the World Health Organization as a strategy to address this challenge. However, this concept is feared to raise specific quality concerns. This research aimed at assessing the performance of health workers to correctly prescribe (target) appropriate antimalarial treatment. Methods: We conducted a cross sectional study at three public health centre IVs in Uganda, with varying malaria transmission intensities (Kihihi-low, Kasambya-medium and Nagongera-high). We categorized prescribers into two groups: specialized prescribers (doctors and clinical officers) and less specialized prescribers (nurses and midwives). At each site, 100 records of patients seen between September and November 2011 and prescribed an antimalarial were retrieved for each group of prescribers. Correctness of the antimalarial drug prescribed and dose given were assessed for each group and compared to the 2005 Uganda national malaria treatment guidelines which recommend Artemether Lumefantrine (AL) for treatment of uncomplicated malaria and Quinine for complicated malaria. Results: Findings of the study showed that specialized health workers were more likely to target correctly as compared to the less specialized health workers [OR = 1.49 (1.00 - 2.22), p = 0.046]. Appropriateness of dosing was higher among specialized prescribers compared to less specialized prescribers however this was not significant [OR = 1.58 0.77 - 3.25), p = 0.206]. Age of the participants, history of fever, diagnosis of malaria and prescription experience were not associated with correct targeting. Conclusion: This study shows that task shifting at the targeting level is not suitable; however, there is inadequate evidence to show that this also applies to anti-malarial dosing. Task shifting for the treatment of Malaria in Uganda should be investigated further using larger studies if it is to be considered as an option for solving the health worker shortages especially in regions with few specialized health workers but high malaria burden.
Financial Management Practices and Health Service Delivery in Uganda Local Governments: A Case Study of Rukungiri District
(International Review of Social Sciences and Humanities, 2014) Byarugaba, Cornelius; Kagambirwe Karyeija, Gerald; Twinomuhwezi, Ivan
This study examined the effect of financial management practices on Health service delivery in Rukungiri District. The study explored the effect of budgeting, financial accountability and financial controls on health service delivery in Rukungiri District. The study adopted a case study and cross sectional survey designs using both quantitative and qualitative approaches. Data was collected from the study population that included district top management and other administration staff, district and NGO health workers, district councilors, Sub-county chiefs, LC.III Chairpersons, and health users who responded to a five point likert scale survey instrument and semi- structure interview guide. Out of a total of sample size of 118 respondents, 117 returned the survey instruments completely filled representing a response rate of 99%. The survey data was analysed using descriptive statistics, correlation and regressional analysis computed using SPSS version 18 and content analysis. The findings revealed that there exists a positive significant relationship between Budgeting and Health service delivery, a positive significant relationship between financial accountability and Health service delivery and a moderate positive significant relationship between financial controls and health service delivery. The study concluded that participatory budgeting was not given attention but left to the top management, that financial accountability was inadequate due to lack of openness, transparency and weak financial systems, and that financial controls are not strictly followed due to poor health monitoring expenditure, technically hard and not reviewed regularly.The study recommends that the district management should put in place a strong budgetary system by involving relevant stake holders, strengthen financial accountability that may help to improve on accountability and transparency and reinforce financial controls such as auditing systems, financial monitoring and other internal controls. This enhances financial management practices hence improved health service delivery.
The Impact of Culture on Performance Appraisal Reforms in Africa: The Case of Uganda’s Civil Service
(Asian Social Science, 2012) Kagambirwe Karyeija, Gerald
This article explores the impact of administrative culture on performance appraisal reforms in Uganda’s civil service. Data gathered from 147 questionnaires, 29 interviews and various documents indicates that administrative culture sabotages the actual conduct of performance appraisals and undermines its institutionalization. The study supports the use of power distance and uncertainty avoidance. The additional dimensions of political (neutrality) biasness and ethnicity are a highly relevant addition to the literature on administrative culture and its linkage to instruments of management. Thus, for the successful introduction of performance appraisals, culture matters because the performance appraisal is imposed from abroad and requires a compatible host administrative culture in order to take root. In this case, the host administrative culture was not compatible in many respects with the values underlying the appraisal reforms. Although the Ugandan government introduced appraisal reforms, incompatibility between the values embedded in the appraisal and the host administrative culture watered down the reform.
The impact of independent members of parliament in multi-party democracies: the Ugandan case
(Africa Journal of Public Sector Development and Governance, 2019) Kagambirwe Karyeija, Gerald
The prominence of political parties as the most appropriate organs for the aggregation of people’s interests and the proper channel for attainment of parliamentary seats may diminish if the trend and interest in non-party candidature continues to grow in developing countries. The phenomenal rise of independent candidates is attributed to the decline in partisanship (Berglund, Holmberg, & Schmitt 2005), the rise of anti-party sentiments (Belanger 2004), internal party democracy flaws, dissatsfaction, personal and selfish reasons, and factionalism. In Uganda, it is widely believed it is as a result of resentment of parties arising from disputes in party primaries. It has continually been evidenced by the number of Independent Members of Parliament (IMPs) who make it to parliament that the independent candidates have been doing well in elections and performing actively in parliament. The number of IMPs in Uganda’s parliament has steadily been rising, from 38 in the Eighth Parliament, to 43 in the Ninth Parliament and now, to 69 in the Tenth Parliament (Parliament of Uganda 2019). The 69 IMPs in the Ugandan parliament are greater in number than the official opposition, which stands at 38. The aim of this paper is to give a perspective on the incidence of IMPs; their relevance and challenges in Uganda. After the introduction, the paper gives the background, followed by the methodology. The fourth section provides a conceptualisation of the incidence of IMPs; explaining why independents run for office. The fifth section deals with the relevance and power of IMPs, globally and in Uganda. Section six looks into the challenges of IMPs. Finally, the last section contains critical reflections for the future of the phenomenon of IMPs.
Influence of Culture on Decision Making in Organizations: Applying Hofstede’s Value Dimensions
(The Ugandan Journal of Management and Public Policy Studies, 2014) Kagambirwe Karyeija, Gerald
Quite often, the decision making process has been understood from the quantitative approach; highly infl uenced by, inter alia, game theory, decision tress and linear programmes. Moreover, there is a preoccupation with rational and economic explanations, political dimensions, procedures, and the institutional framework of public organizations. Yet organizations and the people that work in them have emotions, feelings and context. Thus there is the need for analyzing the decision maker and decision making in the crosscultural context. This paper seeks to draw the relationship between culture and decision making. I explain the process through which policy subsystem arrives at a decision of recommending policy options. The article argues that there is a fruitful intellectual dimension linking culture to decision making an area which is not usually preferred in public administration, on the pretext that culture has limited explanatory power since culture could be broadly considered to mean everything.
Network governance and capacity of local governments to deliver LED in Uganda
(Commonwealth Journal of Local Governance, 2015) Namara, Rose B.; Kagambirwe Karyeija, Gerald; Mubangizi, Betty C.
This paper discusses network governance and its contribution to the capacity of local governments (LGs) to deliver local economic development (LED) in Uganda. Although a formal LED policy was only established in Uganda in February 2014, there have been LED-inspired practices in the past decade. Various scholars and practitioners have observed that the autonomy and capacity of LGs to deliver LED is limited, but have been hopeful that new governance strategies like network governance would increase the capacities of LGs. However, neither network governance arrangements among LGs, nor their potential to improve governance capacity, have been documented. In a case study of Kyenjojo District, this paper finds that existing network governance arrangements have been fundamental in improving financial autonomy at this LG, delivering some income to invest in LED activities, although no evidence was found of reduced transaction costs in transforming local economies. The study further reveals that network governance arrangements have not led to the development of specialised skills in regulation or law enforcement, and capacity gaps are evident amongst staff and members in understanding the private sector and how it works. On a positive note, there is clear evidence of attempts by the LG to be innovative. Based on these findings, this study recommends that LGs need to consider a multi-pronged or multi-network governance approach to LED, which in turn will require a refocusing of governance mechanisms to become more dynamic and responsive, and offer incentives to the various actors in the development sector.
Participation of Workers’ and Employers’ Organizations in Poverty Reduction Strategies in Uganda
(Asian Social Science, 2012) Kagambirwe Karyeija, Gerald; Basheka, Benon C.
It is now over a decade since poverty reduction strategies were embraced by Uganda as a one of the preconditions to reach the debt relief completion point associated with Heavily Indebted Poor Countries (HIPC) initiative. Between 1997 and 2008, the Poverty Eradication Action Plan (PEAP) was the overarching planning framework for the country. The PEAP has been Uganda’s Poverty Reduction Strategy Paper (PRSP), guiding policy formulation and program implementation. In 2007, a review of the PEAP was done culminating into the National Development Plan (NDP), 2010/11 - 2014/15. It has been observed that while the PEAP was being formulated and implemented, the participation of the civil society (including workers and employers organisations) was limited to very few organizations, with no full-time engagement. This was founded on the premise that policy formulation was a preserve of government and the social partners had no business in the process of national planning. The engagement and participation of workers and employers began in 2002, when PEAP was being reviewed. However, the engagement was weak because it had no clear institutional framework. There was commendable participation during the recently concluded National Development Plan. In this article, we used a qualitative case study mainly involving key in depth interviews and documentary analysis. The participation of workers and employers’ organisations’ (Note 1) involvement in the poverty reduction strategies since 1999 is presented in four parts. First, an overview of the socio economic development trends in Uganda is outlined. Second, the concept of social dialogue is outlined. Third, the state of social dialogue in the country is highlighted. Fourth, we analyse the social partners’ participation in the country’s national development planning process.
Performance Appraisal Implementation gaps: Shifting the thinking to Organizational Capacity
(Ugandan Journal of Management and Public Policy Studies, 2020) Musubira, Hilda; Kagambirwe Karyeija, Gerald
This paper examines the drivers for effective implementation of Open Performance Appraisal (OPA) in the Ugandan civil service. It proceeds from the view that organizational culture has often been used as an explanatory variable for performance appraisal implementation. The article is based on critical review of theoretical and empirical literature on implementation drivers, the background of Uganda’s Performance Appraisal system as well as the Organization Readiness. The authors argue that change effi cacy and commitment to change are critical predictors of successful implementation of the open appraisal system in Uganda. The paper concludes that capacity and organizational culture are necessary but not suffi cient factors for effective implementation and notably, capacity is a product of organizational commitment. Similarly, a positive organizational culture can be built in face of sufficient readiness.
Public Sector Reforms in Africa: What Lessons have we Learnt?
(In Forum for Development Studies, 2012) Kagambirwe Karyeija, Gerald
Several public sector reforms (PSR) have taken place in Africa over the last few decades with varying degrees of success; these range from very excellent performance, to limited success and then failure. However, regardless of the evaluation results, they have without a doubt had an impact on the way we understand and shape public management on the African continent. Inevitably, a number of insights and lessons have been gained on the subject matter. In this article, I suggest that a number of lessons have been learnt which should guide reformers to improve on public sector reforms and scholars to seek further explanations for failure and success. There is also the need for students of public sector reforms to question further the prevailing assumptions and theories underpinning these reforms. The 10 lessons highlighted are: (1) there is need to acknowledge the importance of culture and context, because at times local values contradict the content of reform efforts; (2) PSR need both political support and support from the civil society; (3) PSR take time to bear fruit; (4) incremental implementation may be better; (5) not all support for PSR is altruistic; (6) corruption still hinders reform in Africa; (7) there is a need to revisit the role of donors; (8) first things first – let us create a credible public sector before we reform it; (9) ownership of reform programmes by African governments and other stakeholders is necessary; and (10) despite these reforms, Africa still remains poor.
The role of financial institutions towards affordable housing to urban middle income earners: Evidence from Kampala City, Uganda
(African Journal of Social Work, 2014) Atuheire, Kenneth; Kagambirwe Karyeija, Gerald
The general objective of the study was to assess the role of financial institutions towards affordable housing to middle income earners in Kampala City. A sample size of 113 respondents was selected using both probability and non-probability sampling methods. Data was collected and analysed using mixed methods. Findings revealed a weak positive effect (=.312) of mortgage financing towards affordable housing and accounted for 9.7% change in affordable housing. This study also established a moderate positive effect (=.472) of housing loans towards affordable housing and accounted for 22.3% change in affordable housing. Findings further revealed a weak positive effect (=.345) of housing finance on affordable housing and contributed to 11.9% change towards affordable housing. Three major conclusions are made, i.e. a) when access is limited to mortgage financing, access to affordable housing is also limited and need for housing loans arises because they make great sense from a long-term savings perspective. These are useful to social work because the provision of housing extends across all of social work’s various arenas of endeavour, and Uganda is struggling to use housing finances to overcome the housing deficit. Additionally, social work research related to overcoming urban housing deficits adds knowledge to the way Africa is working to meet housing needs for the urban middle class.
Uganda’s National Response to the COVID-19 Pandemic: Measures and Implications for Public Governance
(The International Institute of Administrative Sciences, 2020) Bakenegura Namara, Rose; Nabaho, Lazarus; Kagambirwe Karyeija, Gerald; Nkata, James L.; Lukwago, Rajab
This paper analyses Uganda’s response to the COVID-19 pandemic. Uganda responded to the pandemic decisively –with context-specific measures which were underpinned by science rather than fiction –thus registering quick wins and militating against high infection and death rates which are a norm in other jurisdictions. The efficacy of Uganda’s response is attributed to early preventive strategies that were implemented prior to the identification of first COVID-19 confirmed case, the leadership and decisiveness from the topmost decision making organs, unwavering commitment by political and technical officials, the scientific and social experience of handling previous viral epidemics, consistent communication of the guidelines to the populace, effective coordination of the different institutions and actors, and the involvement and vigilance of the masses. However, the responses were constrained by structural and practical challenges such as the limited resources for the health sector, limited inter-governmental coordination and some hiccups in the implementation processes. The early lessons from the Uganda’s experience underscores the critical role of leadership support, effective coordination and communication mechanisms; and the imperative to pursue whole and multilevel involvement of institutions and actors– including the population– in the fight against global pandemics.

Browsing by Author "Kagambirwe Karyeija, Gerald"

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