Uganda Health Sector Financing - Adequacy, Efficiency, and Equity - Technical Report - July 2026

Jul 19, 2026

Technical analysis of Uganda’s health sector financing examines how adequacy and composition of health spending shape service delivery. The report evaluates efficiency across budgeting, procurement and supply chains, medicines use, workforce productivity, distribution, absenteeism, and hospital performance. It also assesses equity by measuring catastrophic health spending, impoverishment risks, benefit incidence, geographic workforce distribution, and district-level public primary health care spending. Findings inform policy directions for improved fiscal allocation, execution, and reforms under a constrained financing environment.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages60

Reading Time2 h 31 min

AccessFree to download

Acknowledgments

Executive Summary

Context

Adequacy and composition of health spending

Synopsis of Overall Health Spending

Trends in Government Health Expenditure

Composition of Domestic Government Health Expenditure

Contribution of Public Spending to Current Health Expenditure

External Financing

Recent Cuts in Development Assistance for Health: Impacts, Government Response, and the New USG–GoU MoU

Medium-Term Fiscal Outlook for Government Health Spending

Findings and Policy Directions

Efficiency of Health Spending

Overview of Health Spending Efficiency in Uganda

Benchmarking Health Spending Efficiency Against Peer Countries

Medicines Procurement, Supply Chain, and Rational Use

Health Workforce Productivity, Distribution, and Absenteeism

Hospital Efficiency, Bed Utilization, Length of Stay, and Patient Flow

Budget Execution

Findings and Policy Directions

Financial Hardship and Equity of Health Spending

Introduction

Financial Hardship: Catastrophic Health Spending and Impoverishment

Benefit Incidence Analysis: Who Benefits from Public Health Spending in Uganda

Equity of Public PHC Spending Across Districts

Geographic Distribution of the Health Workforce

Government Reforms Addressing Financing Equity

Conclusions And Policy Agenda

References

Annex Figure

Uganda Health Sector Financing, blisclosure Authorized u li iD sc os re Authorized Public Disclosure Authorized Disc losure Authorized ADEQUACY, EFFICIENCY, AND EQUITY Technical Report and Background Note to the Uganda Public Finance Review JULY 2026 Public © 2026 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW, Washington DC 20433 Telephone: 202-473-1000; [Internet: www.worldbank.org](Internet: www.worldbank.org) [Some rights reserved.](Some rights reserved.) This work is a product of The World Bank. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of the Executive Directors ofThe World Bank or the governments they represent. The World Bank does not guarantee the accuracy, completeness, or currency of the data included in this work and does not assume responsibility for any errors, omissions, or discrepancies in the information, or liability with respect to the use of or failure to use the information, methods, processes, or conclusions set forth. The boundaries, colors, denominations, links/footnotes and other information shown in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory orthe endorsement or acceptance of such boundaries. The citation of works authored by others does not mean the World Bank endorses the views expressed by those authors or the content of their works. Nothing herein shall constitute or be construed or considered to be a limitation upon or waiver of the privileges and immunities of The World Bank, all of which are specifically reserved. Rights and Permissions The material in this work is subject to copyright. Because The World Bank encourages dissemination of its knowledge, this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work is given. Attribution—Please cite the work as follows: “World Bank. 2026. Uganda Health Sector Financing Adequacy, Efficiency, and Equity, technical report. Washington, D.C. © World Bank.” Any queries on rights and licenses, including subsidiary rights, should be addressed to World Bank Publications, The World Bank, 1818 H Street NW, Washington, DC 20433, USA; [email: pubrights@worldbank.org](email: pubrights@worldbank.org). i Uganda Health Sector Financing Adequacy, Efficiency, and Equity Technical Report July 2026 ii Acknowledgments The health background note to the Uganda Public Finance Review (PFR) was prepared by a World Bank team comprising Rogers Ayiko, Senior Health Specialist and Munirat Iyabode Ayoka Ogunlayi, Senior Health Specialist (HAEH2); Mariam Ally, Senior Economist (WKHH1); Angellah Irene Nakyanzi, Consultant (WKHHF); Antoine Pierre Michel Lacroix, Consultant; and Damalie Evalyne Nyanja, Senior Program Assistant (AEMUG) . The review was prepared under the supervision of Ronald Upenyu Mutasa, Practice Manager (HAEH2) and received technical input from Peter Okwero, Senior Health Specialist and Faith Makhosazana Phelakwakhe Mamba, Senior Economist (HAEH2), and Owen K. Smith, Lead Economist (HAWH3) . The team appreciates the excellent collaboration with the Government of Uganda and gratefully acknowledges technical input from the following Ministry of Health Officials: John Kauta (Commissioner), Kabagambe Richard (Assistant Commissioner), and Aliyi Walimbwa (Principal Planner) . The 2026 Uganda Public Finance Review can be accessed at the link below: [https://documents.worldbank.org/en/publication/documents-reports/documentdetail/099062626073561730](https://documents.worldbank.org/en/publication/documents-reports/documentdetail/099062626073561730) iii Table of Contents Acknowledgments ii List of Acronyms v Executive Summary vi 1. Context 1 2. Adequacy and composition of health spending 5 2.1 Synopsis of Overall Health Spending 5 2.2 Trends in Government Health Expenditure 5

FAQs

What dimensions of health spending does the report assess?

It evaluates adequacy and spending composition, efficiency across systems and service delivery, and equity through measures of financial hardship and distribution of benefits and health workers.

How does the report analyze efficiency in Uganda’s health sector?

Efficiency is examined through medicines procurement and supply chains, rational use, health workforce productivity and absenteeism, hospital performance indicators, and budget execution performance.

Which equity and financial hardship outcomes are covered?

The report covers catastrophic health spending and impoverishment, benefit incidence of public health spending, district-level equity in primary health care spending, and the geographic distribution of the health workforce.

Jul 19, 2026

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