Health policy analysis institutes: landscaping and learning from experience, Uganda
Case study of Uganda’s Policy Analysis Unit in the Ministry of Health
The multi-national landscaping study of Health Policy Analysis Institutes supported by the Alliance HPSR and funded by the Rockefeller Foundation aims to achieve three goals: (i) mapping existing national and regional health policy analysis institutes and initiatives; (ii) deriving lessons about the different organizational models and factors that contribute to the effectiveness and sustainability of such institutes and (iii) making recommendations to the Rockefeller Foundation and other stakeholders about how best to support the development of health policy analysis institutes in low- and middle-income countries (LMICs).
Uganda’s Policy Analysis Unit (PAU) in the Ministry of Health (MOH) was selected as the case study to illustrate the Ugandan experience and thus contribute to an understanding of the underlying causes of weak domestic capacity for this type of work. Data was collected through semi-structured in-depth key informant interviews, document review, factual analyses and direct observation.
Findings: The creation of policy analysis units in all line ministries in Uganda followed the implementation of the 1998 Public Service Reform Programme. These units were instituted to streamline how policies are effectively implementable and in accord with other national policies and programmes. A policy analysis unit is additionally entrusted with the responsibility of formulating, reviewing, analyzing researched policies and regulations for the sector and advising the Permanent Secretary (PS) on desirable policy changes.
The Policy Analysis Unit in the Ministry of Health became effective in 1999, and since that time it has been both under-facilitated, under-funded and under-performing. The unit has, since early 2008, had only one staff member, who is ill- equipped in both equipment and the necessary skills for policy analysis. The main challenges thus include insufficient staff numbers and skill mix, unclear reporting lines, lack of funding for activities, and the overlapping of roles with other units like Resource Centre, Planning Division and Quality Assurance Department.
Despite these challenges, there has been a renewed interest to operationalize the unit by the current MOH senior management, and a willingness of key stakeholders like the World Health Organization (WHO) and Ugandan universities to take on a more active role to ensure the unit’s functionality. There is also a strong domestic capacity for policy analysis, located in both public and private universities - which, if mobilized, could improve policy analysis in the country. Strategies for improvement of the unit rotate around revitalizing the current unit in the MOH and creation of an independent policy analysis unit.
Conclusions:
The present capacity of the Policy Analysis Unit, in terms of hierarchical status, staff skills and mix, infrastructure, equipment and level of funding, faces numerous constraints. The capability to do policy analysis, in terms of tasks involved and skills required, is also very low.
The need for an effectively performing policy analysis unit was echoed by all respondents and is further supported by both local and international literature. The escalating demand for equitable health services, the political multi-party governance of the country, the Sector Wide Approaches (SWAP) to health development, the public-private partnerships for health in Uganda and emerging global initiatives for health call for vibrant policy analysis capacity and capability.
If the performance of the sector is to improve, policy formulation needs to be supported by timely, understandable, reliable, accessible and useful information. The strengthening and supporting of the present Health Policy Analysis Unit, within the present government framework, is necessary in order to ensure readily available internal capacity for research materials evaluation and policy formulation, monitoring and evaluation.
The decision on the best options for a health policy analysis unit in Uganda requires further dialogue and consensus building. Nevertheless, whichever option is finally decided upon must take into consideration: sustainability; autonomy; capacity; and the ability to influence policy decisions.
Project description
Programme: Health policy analysis institutes: landscaping and learning from experience
Research title: Case study of Uganda’s Policy Analysis Unit in the Ministry of Health
Thematic Research Area: Evidence to Policy
Grantee Country: Uganda
Grantee Institution: to be completed
Program Coordinator/Principle Investigator:Joseph Herman Kyabaggu and Grace Namaganda
Start date: September 2009
Status of grant: Completed (November 2010)