Competencies of lower-level community health centre leaders in annual health work planning and their influence on district performance in Busoga sub-region: A retrospective study

Introduction: Lower-level community health centres play a crucial role in the delivery of primary healthcare services, and the competencies of their leaders can significantly influence district performance. Annual health work planning in local governments faces implementation obstacles every year. This mostly affects lower-level community health centres in Busoga region. It is evidenced by late submission of annual health work plans to authorized offices and also these work plans are poorly made by lower-level community health centres in Busoga region. This prompted a retrospective study to understand the competencies of leaders in the lower-level community health centres in annual health work plan development. Objective: The study assessed the influence of competencies of lower-level community health centre leaders in annual health work planning on the district performance in Busoga region. Methods: A retrospective (case-control) study design was employed to understand health centre performance across various districts in Busoga sub-region. There was a comparison of performance between the worst performing (case) and best performing (control) districts in the region according to the Annual Health Sector Performance reports from 2017/18 financial year to 2021/2022. Leaders in the lower-level community health centres were recruited to participate in the study. Data was collected between 17th July, 2024 and 23rd August, 2024. Statistical analysis was conducted on data from 12 case health centres and 12 control health centres using STATA version 16 to determine competencies of lower-level community health centre leaders that influence district performance. Results: The study found that the district performance in annual health work planning was poor in both the case and control groups (26.4% and 47.2% respectively). Only three competencies variables of lower-level community health centre leaders were significantly influencing the performance of the districts. Districts with health facilities which reported that their Health Unit Management Committees (HUMCs) were fully constituted as guided by their leaders for annual health work planning, had significantly higher odds (AOR = 13.551, 95% CI: 4.816–38.617, p