Analysis of financial management in Public Emergency Medical Services sector : Case study of the Department of Emergency Medical Services, Uganda

Abstract

The purpose of the study was to critically analyze financial management of the public EMS sector with specific focus on the financing method for public EMS. The objectives were to identify the sources of funding currently being used to cover the cost of running EMS. analyse the factors responsible for financial constraints of EMS and to design a strategic framework to improve the financial management of EMS in Uganda. The study utilized a descriptive cross-sectional survey design. The study was a mixed approach of both qualitative and quantitative approaches. It was conducted in the Department of EMS at the Ministry of Health. A census was conducted for all twenty-one members of the Department of EMS. Data was collected with the use of a questionnaire and key informant interviews. The prominent sources of funding towards EMS in Uganda included government, development partners and charity organizations. The most highlighted factors constraining financial management of EMS included reduced government funding, bureaucracies within government agencies and increasing costs of running EMS. The major strategies to improve on this financial constraint included formation of a national insurance scheme, increasing government’s contribution and public private partnerships. In conclusion, the department seemed to be taking on the trend of the developed world in form of strategies to combat financial management constraints which is a step in the right direction but should be cognizant of the challenges this could bring on due to adaptation of these practices. The department of EMS still had a narrow scope of funding sources mainly circling around government and development partner support and was utilizing less of the more revolutionary sources that have redefined EMS in the developed world for the better. The Department of EMS is recommended to take on more options as funding sources to expand their funding base. These include a national health insurance scheme, group fee contributions, third party insurance utilization among others.