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The strategy to support districts financially empowers them to develop their own ways of tackling malnutrition at decentralized levels.
Accountability becomes unclear and transparency can be lacking, with problems of patronage occurring at decentralized levels as well.
Based on the study, the Uganda Ministry of Health has begun disseminating results and guidelines for gender mainstreaming into human resources management at decentralized levels to raise awareness of these issues with district health managers.
Despite the intentions to expand HR functions at decentralized levels from personnel administration to more comprehensive HRH management, insufficient investments were made to assure that HRH units had managers with the required competencies.
This includes sensitizing managers to the importance of EHA, scaling the level of evaluation effort to the specific accountability and learning needs at hand, and ensuring adequate EHA capacity; (b) The Evaluation Office should continue its support for enhancing EHA capacity at decentralized levels.
In these three countries, despite (or because of) a public administration that was still highly centralized, it was decided some time after the exemption measures' implementation to delegate the policy-monitoring responsibility to persons at decentralized levels of the Ministry of Health.
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The programme will also support implementation of child-sensitive policies enforced at national and at decentralized level.
In addition, the documemt clearly articulates social vulnerabilities and the need to hire and deploy 6000 social work case managers to facilitate an integrated approach to social services at decentralized level.
Recent studies demonstrate that good governance, especially at the decentralized levels, can improve health outcomes [ 6, 7].
Budget limitations have reduced the EO's ability to strengthen UNICEF's internal evaluation capacity at the decentralized levels, in spite of the Executive Board's having identified this as a priority focus.
However, the Panel agrees with the EO's self-assessment that improvements are needed in the areas of (1) strengthening evaluation capacity at the decentralized levels (regional/country offices, partner countries), and (2) disseminating evaluation results and lessons more effectively.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com