Too often, government leaders fail to adopt and implement policies that they know are necessary for sustained economic development. Political constraints can prevent leaders from following sound technical advice, even when leaders have the best of intentions. Making Politics Work for Development: Harnessing Transparency and Citizen Engagement focuses on two forces—citizen engagement and transparency—that hold the key to solving government failures by shaping how political markets function.

A number of approaches have been adopted in medical education geared towards training health professionals that can improve access to health care by communities most vulnerable to inequalities and injustices in health systems. Relevant health professions education is vital for improvements in health and health care access. A symbiotic medical education can improve the quality of health care and impact on career choice, yet the challenge to sustain equitable access to improved health and healthcare particularly for those most in need remains a major global challenge ( Ssewankambo, 2012). Within a decentralized system, such as in Uganda, Local Governments are mandated to ensure health promotion and equitable healthcare for the population under their jurisdiction. Whereas public service reforms have mainly focused on decentralization and good governance (Mamdani, 2012, Stiglitz, 2012), the role of curriculum reforms in addressing health and health care challenges through needs-based education of health professionals has been largely ignored. Through an analysis of the challenges of health care within a decentralized Local Government setting, this paper, by presenting experiences from one public university in Uganda, reveals how a partnership between Universities and Local Government can go a long way in addressing health disparities and reduction of morbidity and mortality.

The Government of Uganda established external agencies as part of the control mechanisms aimed at promoting accountability in the public sector in general and local governments (LGs) in particular. The two cardinal control agencies include the Office of the Auditor General (OAG) and the Inspectorate of Government (IG), who are mandated to enhance public service through efficient and effective resource management, ensuring adherence to standards and regulations, and promoting responsiveness to community needs. In spite of these institutional controls, a surge of unbearable events involving abuse of authority and misuse of public resources still exists, suggesting significant managerial and capacity handicaps, not only in the internal mechanisms of LGs, but also in the external control agencies. This paper presents findings of a study conducted to evaluate the institutional capacity of the OAG and the IG in the enhancement of accountability in local governments (LGs) in Uganda. The findings demonstrate deficiencies in institutional capacity across the spectrum of financial, human and material resources, as well as the enabling legislation and lack stakeholder support. The scenario is a recipe for encouraging public malfeasance. The paper makes a strong case for strengthening institutional capacity, through improvements in planning, resource facilitation and collaborative relations among the key stakeholders. It is argued that the establishment of a special anti-corruption court could help reduce the delays and provide appropriate corrective measures in support of accountability.

This report was prepared by the International Labour Office as the basis for discussions at the Joint Meeting on the Impact of Decentralization and Privatization on Municipal Services to be held from 15 to 19 October 2001 in Geneva.