Abstract

This study investigates the relationship between decentralization and service quality in
Bwera District Hospital, focusing on fiscal, political, and administrative decentralization.
The target population is health workers at the hospital, and a simple random technique
was used to reach the sample. Data was collected through closed open questionnaires and
analyzed using the Statistical Package of Social Sciences (SPSS). The findings indicate that
fiscal decentralization has improved service quality, political decentralization has
empowered community members, and administrative decentralization has significantly
influenced service quality. The study recommends more debate and bargaining on the
balanced distribution of fiscal resources among different districts, local governments
controlling their own-source revenues to allow some discretion in matching citizens'
needs with taxes paid, and the government of Uganda partnering with its agencies to
build capacity at lower levels of communities through better intergovernmental transfers