Budgeting practices, public value and quality of health care budgeting practices public value services in public health facilities in Bukedi sub-region.
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Date
2026
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Busitema University
Abstract
This study examined the effect of budgeting practices on the quality of health care services inpublic health facilities in Bukedi sub-region, Uganda, and further investigated the mediating role of public value in this relationship. The study was anchored on Stakeholder Theory and adopted a cross-sectional survey research design. The target population comprised 185 public health facilities in Bukedi sub-region, from which a sample of 127 public health facilities was selected using the Krejcie and Morgan (1970) sample size determination approach. Data were collected using a structured questionnaire administered to personnel involved in budgeting, administration and health service delivery in the selected public health facilities. The study obtained responses from 97 public health facilities, representing a response rate of 76.37%. The instrument demonstrated satisfactory validity and reliability, with Content Validity Index values ranging from 0.71 to 0.78 and Cronbach's alpha coefficients ranging from 0.954 to 0.962. Data were analysed using descriptive statistics, Pearson correlation, hierarchical regression, simple linear regression and mediation analysis using the Sobel test.
The findings revealed that budgeting practices had a positive and statistically significant effect on quality of health care services (ß = 0.422, p < 0.001). Further, public value had a positive and statistically significant effect on quality of health care services (ß = 0.423, p < 0.001). The study also established that budgeting practices had a positive and statistically significant effect on public value (ß = 0.485, p < 0.001). The mediation analysis further revealed that public value significantly and partially mediated the relationship between budgeting practices and quality of health care services (Sobel Z = 3.421, p = 0.001). The effect of budgeting practices on quality of health care services reduced from ß = 0.422 to ß = 0.216 after the introduction of public value, while the indirect effect was 0.206, indicating that 48.8% of the total effect was transmitted through public value.
The study concludes that effective budgeting practices contribute significantly to improved quality of health care services and enhanced public value in public health facilities. It further concludes that public value constitutes an important mechanism through which budgeting practices influence quality of health care services, although budgeting practices also retain a significant direct effect. The study therefore recommends that the Ministry of Health and district health management teams strengthen budgeting capacity among health facility managers, improve transparency and accessibility of budget information, institutionalize participatory budgeting mechanisms, and incorporate public value indicators such as stakeholder trust, legitimacy and outcome achievement into health facility performance monitoring systems.
Keywords: Budgeting practices, public value, quality of health care, health care, public value services, public health facilities, Bukedi sub-region
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Nagodyo, A. (2026). Budgeting practices, public value and quality of health care budgeting practices public value services in public health facilities in Bukedi sub-region. [Unpublished dissertation]. Busitema University.