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Health versus other sectors: Multisectoral resource allocation preferences in Mukono district, Uganda

Author

Listed:
  • Tatenda T Yemeke
  • Elizabeth E Kiracho
  • Aloysius Mutebi
  • Rebecca R Apolot
  • Anthony Ssebagereka
  • Daniel R Evans
  • Sachiko Ozawa

Abstract

Objectives: To elicit citizen preferences for national budget resource allocation in Uganda, examine respondents’ preferences for health vis-à-vis other sectors, and compare these preferences with actual government budget allocations. Methods: We surveyed 432 households in urban and rural areas of Mukono district in central Uganda.We elicited citizens’ preferences for resource allocation across all sectors using a best-worst scaling (BWS) survey. The BWS survey consisted of 16 sectors corresponding to the Uganda national budget line items. Respondents chose, from a subset of four sectors across 16 choice tasks, which sectors they thought were most and least important to allocate resources to. We utilized the relative best-minus-worst score method and a conditional logistic regression to obtain ranked preferences for resource allocation across sectors. We then compared the respondents’ preferences with actual government budget allocations. Results: The health sector was the top ranked sector where 82% of respondents selected health as the most important sector for the government to fund, but it was ranked sixth in national budget allocation, encompassing 6.4% of the total budget. Beyond health, water and environment, agriculture, and social development sectors were largely underfunded compared to respondents’ preferences. Works and transport, education, security, and justice, law and order received a larger share of the national budget compared to respondents’ preferences. Conclusions: Among respondents from Mukono district in Uganda, we found that citizens’ preferences for resource allocation across sectors, including for the health sector, were fundamentally misaligned with current government budget allocations. Evidence of respondents’ strong preferences for allocating resources to the health sector could help stakeholders make the case for increased health sector allocations. Greater investment in health is not only essential to satisfy citizens’ needs and preferences, but also to meet the government’s health goals to improve health, strengthen health systems, and achieve universal health coverage.

Suggested Citation

  • Tatenda T Yemeke & Elizabeth E Kiracho & Aloysius Mutebi & Rebecca R Apolot & Anthony Ssebagereka & Daniel R Evans & Sachiko Ozawa, 2020. "Health versus other sectors: Multisectoral resource allocation preferences in Mukono district, Uganda," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-15, July.
    • Handle: RePEc:plo:pone00:0235250
    DOI: 10.1371/journal.pone.0235250
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    1. Mickael Bech & Dorte Gyrd‐Hansen, 2005. "Effects coding in discrete choice experiments," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1079-1083, October.
    2. Flynn, Terry N. & Louviere, Jordan J. & Peters, Tim J. & Coast, Joanna, 2007. "Best-worst scaling: What it can do for health care research and how to do it," Journal of Health Economics, Elsevier, vol. 26(1), pages 171-189, January.
    3. Kei Long Cheung & Ben F. M. Wijnen & Ilene L. Hollin & Ellen M. Janssen & John F. Bridges & Silvia M. A. A. Evers & Mickael Hiligsmann, 2016. "Using Best–Worst Scaling to Investigate Preferences in Health Care," PharmacoEconomics, Springer, vol. 34(12), pages 1195-1209, December.
    4. Jordan Louviere & Terry Flynn, 2010. "Using Best-Worst Scaling Choice Experiments to Measure Public Perceptions and Preferences for Healthcare Reform in Australia," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 3(4), pages 275-283, December.
    5. Potoglou, Dimitris & Burge, Peter & Flynn, Terry & Netten, Ann & Malley, Juliette & Forder, Julien & Brazier, John E., 2011. "Best-worst scaling vs. discrete choice experiments: An empirical comparison using social care data," Social Science & Medicine, Elsevier, vol. 72(10), pages 1717-1727, May.
    6. Jennifer A. Whitty & Julie Ratcliffe & Gang Chen & Paul A. Scuffham, 2014. "Australian Public Preferences for the Funding of New Health Technologies," Medical Decision Making, , vol. 34(5), pages 638-654, July.
    7. Axel C. Mühlbacher & Peter Zweifel & Anika Kaczynski & F. Reed Johnson, 2016. "Experimental measurement of preferences in health care using best-worst scaling (BWS): theoretical and statistical issues," Health Economics Review, Springer, vol. 6(1), pages 1-12, December.
    8. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    9. Peter Okwero & Ajay Tandon & Susan Sparkes & Julie McLaughlin & Johannes G. Hoogeveen, 2010. "Fiscal Space for Health in Uganda," World Bank Publications - Books, The World Bank Group, number 5949, December.
    10. Xesfingi, Sofia & Vozikis, Athanassios, 2014. "Citizens’ Preferences on Health Care Expenditure Allocation: Evidence from Greece," MPRA Paper 63419, University Library of Munich, Germany.
    11. Helen V. Milner & Daniel L. Nielson & Michael G. Findley, 2016. "Citizen preferences and public goods: comparing preferences for foreign aid and government programs in Uganda," The Review of International Organizations, Springer, vol. 11(2), pages 219-245, June.
    12. Axel C. Mühlbacher & Anika Kaczynski & Peter Zweifel & F. Reed Johnson, 2016. "Experimental measurement of preferences in health and healthcare using best-worst scaling: an overview," Health Economics Review, Springer, vol. 6(1), pages 1-14, December.
    13. Susan dosReis & Xinyi Ng & Emily Frosch & Gloria Reeves & Charles Cunningham & John Bridges, 2015. "Using Best–Worst Scaling to Measure Caregiver Preferences for Managing their Child’s ADHD: A Pilot Study," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(5), pages 423-431, October.
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