Local government is one of Uganda’s iconic democratic symbols, especially in the manner in which it transfers power and functions from central government to local governments, and promotes public participation at the lowest levels through established structures. Provision of health care is one of the key state directive principles. Under the Constitution, health and health policy is a competency of the central government. At the same time, the Constitution and allocates functions to districts to provide services which are important in the realisation of public health care. It is noted that the Constitution also adheres to a socio-economic rights paradigm. This demands that the district commands adequate human resources, technical capacity and financial resources to execute its tasks. The seemingly vague definition of the sharing of health care competency between the central government and local governments undermines the integrity of local governments as cornerstones of social health developmental. Besides, the absence of clearly defined power and functions in respect of public health between the central government and the local governments convolutes the distinct roles between the two orders of government. Ultimately, the above convolution of roles undermines the idea of co-operative governance, a common feature in both decentralised and federal governments.
