Theoretical Review of Pay Restructuring in Uganda's Public Service Health Sector
Open accessAbstract
This article examines the impact of wage reforms on service delivery, financial stability, managerial efficiency and donor influence and focuses on the public health sector in Uganda. Like other reforming countries, Uganda also implemented salary structure reform for various reasons, but the most important ones were to pay civil servants a living wage, make remuneration transparent, align the salary structure with the single-spine structure and consequently increase the number of employees motivation and efficiency in service delivery. The study analysed research articles, policy documents, reports, and media coverage on pay changes for public health workers. Key findings show that the original goal of wage reforms, such as the single-spine structure, has not been achieved; several pay scale structures were reintroduced. Different service models are used to calculate wage. Similar cadres of civil servants receive different salary grades; and wage allocation receives more funding than other areas, such as development and supplies. The results suggest that salary increases affect allocations in other important areas but do not always result in public health workers' commitment to service. Compromise and negotiation have played an important role in public sector wage restructuring. A review of wage reforms implemented across Uganda's public sector will be based on the recommendations and issues addressed in this study. The study provides crucial benchmarks with regard to wage reform strategies that promote diversity in the public sector and the distribution of authorities. This study is unique because it focuses on wage restructuring in the public sector to align practices with policies. Although based on a review of relevant documents, it was conducted for the first time in Uganda
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Uganda has seen reforms by the Ministry of Public Service to enhance service delivery by re-organizing compensation, retention efforts and expanded public service reform.
“Uganda has seen reforms by the Ministry of Public Service to enhance service delivery by re-organizing compensation, retention efforts and expanded public service reform (Olum et al., 2024).”
From Rewards and Employee Performance in Government Agencies: Evidence from Kampala Capital City Authority (KCCA), Uganda (2026) · cites this paper as Olum et al., 2024
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
McPake, B., Witter, S., Ensor, T., Fustukian, S., Newlands, D., Martineau, T., & Chirwa, Y. (2013) · Human Resources for Health · doi:10.1186/1478-4491-11-46 · Cited by 79 · see citing works
Flagged first, then by citations
Research works printed but not linked: 36
- Berry, L. L., Zeithaml, V. A., & Parasuraman, A. C. S. Q. (1990). Five imperatives for improving service quality. MIT Sloan Management Review, 31(4), 29.
- Brignall, S., & Modell, S. (2000). An institutional perspective on performance measurement and management in the 'new public sector'. Management Accounting Research, 11(3), 281-306.
- Bulthuis, S. E., Kok, M. C., Raven, J., & Dieleman, M. A. (2020). Factors influencing the scale-up of public health interventions in low-and middle-income countries: a qualitative systematic literature review. Health Policy and Planning, 35(2), 219-234.
- Cassels, A. (1995). Health sector reform: key issues in less developed countries. Journal of International development, 7(3), 329-347.
- Clayton, R., & Pontusson, J. (1998). Welfare-state retrenchment revisited: entitlement cuts, public sector restructuring, and inegalitarian trends in advanced capitalist societies. World politics, 51(1), 67-98.
- Crook, R. C. (2010). Rethinking civil service reform in Africa: 'islands of effectiveness' and organisational commitment. Commonwealth & Comparative Politics, 48(4), 479-504.
- Curristine, T., Lonti, Z., & Joumard, I. (2007). Improving public sector efficiency: Challenges and opportunities. OECD journal on budgeting, 7(1), 1-41.
- Deaton, A. S., & Tortora, R. (2015). People in sub-Saharan Africa rate their health and health care among the lowest in the world. Health Affairs, 34(3), 519-527.
- Dreher, G. F. (1981). Predicting the salary satisfaction of exempt employees. Personnel Psychology, 34(3), 579-589.
- Eberts, R. W., & Stone, J. A. (1986). On the contract curve: A test of alternative models of collective bargaining. Journal of Labor Economics, 4(1), 66-81.
- Emuron, L. (2020). Progressive reward management system model for university governance. International Journal of Advanced Research and Publications, 4(4), 129-138.
- Fritzen, S. A. (2007). Strategic management of the health workforce in developing countries: what have we learned? Human resources for health, 5(1), 1-9.
- Ggoobi, R. (2023, July 18). Press brief on Quarter one expenditure releases FY2023/24. (M. a. Stakeholders, Interviewer) https://www.finance.go.ug/sites/default/files/ press/PRESS%20BRIEF%20ON%20QUAR TER%20ONE%20EXPENDITURE%20REL EASES%20FY%202023-24.pdf:
- Hagopian, A., Zuyderduin, A., Kyobutungi, N., & Yumkella, F. (2009). Job satisfaction and being trained? https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC2654639/
- Kingma, M. (2018). Nurses on the move: Migration and the global health care economy. Cornell University Press.
- Krogstad, U., Hofoss, D., Veenstra, M., & Hjortdahl, P. (2006). Predictors of job satisfaction among doctors, nurses, and auxiliaries in Norwegian hospitals: relevance for micro unit culture. Human resources for health, 4(1), 1-8.
- Kyaddondo, D., & Whyte, S. R. (2003). Working in a decentralised system: a threat to health workers' respect and survival in Uganda. The International journal of health planning and management, 18(4), 329-342.
- Lee, L. F. (1978). Unionism and wage rates: A simultaneous equations model with qualitative and limited dependent variables 19(2). International economic review, 415- 433.
- Maniple, E. B. (2015). " I found myself staying"- A case study of the job embeddedness and retention of qualified health workers in rural and remote areas of Uganda (Doctoral dissertation, Royal College of Surgeons, Ireland).
- Ministry of Health. (2021). Aide Memoire 27th National Health Sector Joint Review Mission. Kampala: Ministry of Health. Ministry of Health: http://154.72.196.19/human- resources-health/performance- management/27th-national-health-sector- joint-review-mission-aide Ministry of Public Service, (2022). Circular Standing Instruction (CSO) No.1.of 2022. Kampala: Ministry of Public Service.
- Mosadeghrad, A. M. (2014). Factors influencing healthcare service quality. International journal of health policy and management, 3(2), 77.
- Moyimane, M. B., Matlala, S. F., & Kekana, M. P. (2017). Experiences of nurses on the critical shortage of medical equipment at a rural district hospital in South Africa: a qualitative study. Pan African Medical Journal, 28(1), 157-157.
- Munabi-Babigumira, S., Nabudere, H., Asiimwe, D., Fretheim, A., & Sandberg, K. (2019). Implementing the skilled birth attendance strategy in Uganda: a policy analysis. BMC health services research, 19(1), 1-15.
- Muthuri, R. N. D. K., Senkubuge, F., & Hongoro, C. (2020, June). Determinants of motivation among healthcare workers in the East African community between 2009-2019: a systematic review. In Healthcare (Vol. 8, No. 2, p. 164). MDPI.
- Nannyonjo, J., & Okot, N. (2013). Decentralisation, local government capacity and efficiency of health service delivery in Uganda. Journal of African Development, 15(1), 125-158.
- Okoroafor, S. C., Ongom, M., Mohammed, B., Salihu, D., Ahmat, A., Osubor, M., ... & Alemu, W. (2021). Perspectives of policymakers and health care managers on the retention of health workers in rural and remote settings in Nigeria. Journal of Public Health, 43(Supplement_1), i12-i19.
- Olowu, B. (1999). Redesigning African civil service reforms. The Journal of Modern African Studies, 37(1), 1-23.
- Peiffer, C., Armytage, R., Marquette, H., & Gumisiriza, P. (2021). Lessons from reducing bribery in Uganda's health services. Development Policy Review, 39(5), 721-739.
- Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing & Health Sciences, 15(3), 398-405.
- Vian, T., Miller, C., Themba, Z., & Bukuluki, P. (2013). Perceptions of per diems in the health sector: evidence and implications. Health Policy And Planning, 28(3), 237-246.
- Vlaev, I., Schmidtke, K. A., Balen, J., & Dormon, F. (2017). Healthworkers' motivation in low- and middle-income countries: A systematic review of the literature. Medical Research Archives, 5(8).
- Walt, G., & Gilson, L. (1994). Reforming the health sector in developing countries: the central role of policy analysis. Health Policy And Planning, 9(4), 353-370.
- Willis-Shattuck, M., Bidwell, P., Thomas, S., Wyness, L., Blaauw, D., & Ditlopo, P. (2008). Motivation and retention of health workers in developing countries: a systematic review. BMC Health Services Research, 8, 1- 8.
- Witter, S., Bertone, M. P., Chirwa, Y., Namakula, J., So, S., & Wurie, H. R. (2016). Evolution of policies on human resources for health: opportunities and constraints in four post- conflict and post-crisis settings. Conflict and Health, 10(1), 1-18.
- Wynn, R. (1970). Collective bargaining. The Phi Delta Kappan, 51(8), 415-419.
- Zakumumpa, H., Rujumba, J., Amde, W., Damian, R. S., Maniple, E., & Ssengooba, F. (2021). Transitioning health workers from PEPFAR contracts to the Uganda government payroll. Health Policy and Planning, 36(9), 1397-1407.
Cited by
Sorted by citations
Okelloa, O. K., Alochere, D. B. J., & Norman, N. (2026) · International Journal of Research and Innovation in Applied Science · doi:10.51584/ijrias.2026.110400073
- Authors
- Olum, S., Adyanga, A. F., & Ocan, J.
- Affiliations
- Kabale University (UG)
- ORCID
- Ocan, Johnson
- Venue
- International Journal of Advanced Research
- Published
- 2024-01-11
- Volume
- 7
- Issue
- 1
- Pages
- 35-54
- ISSN
- 2707-7802 (ISSN-L)
- 2707-7810
- OpenAlex
- W4390740248
- Cited by
- 2
- References
- 1
- Citations by year
- 2026: 1 · 2024: 1
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- diamond
- dx.doi.org
- Locations
- International Journal of Advanced Research (publishedVersion, cc-by)
- Kabale University Digital Repository (submittedVersion)
- Topics
- Social Sciences › Public Administration › Public Policy and Administration Research
- Social Sciences › Political Science and International Relations › Public Administration in Developing Nations
- Social Sciences › Economics, Econometrics and Finance › Finance › Healthcare Systems and Reforms
- Keywords
- wage reform, public health sector, public sector wages, living wage, civil servant salaries, service delivery, donor influence, wage allocation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review