Evaluating effects of local-level outside government gender budget initiatives: an application of theory-based evaluation, process tracing and a quasi-experiment in Kabale, Uganda

Date: 20 December 2016

Venue: UAntwerp, Hof van Liere, Willem Elsschotzaal - Prinsstaat 13 - 2000 ANTWERP (route: UAntwerpen, Stadscampus)

Time: 4:00 PM - 6:00 PM

Organization / co-organization: IOB

PhD candidate: Patricia Bamanyaki

Principal investigator: Prof Nathalie Holvoet - Prof Henry Manyire

Short description: PhD defence Patricia Bamanyaki - IOB


Although decades have witnessed the implementation of numerous interventions to improve maternal health outcomes, maternal mortality remains a pronounced problem, particularly in Sub Saharan Africa and South East Asia. Growing literature acknowledges that maternal morbidity and deaths are not just a consequence of biological factors, but also structural, socioeconomic and cultural factors. Various studies also link undesirable maternal health outcomes to poverty and gender inequality. Since the late 1990s, gender responsive budgeting has emerged as a popular tool for governments to meet their commitments towards gender equality, women’s empowerment and the realisation of women’s rights. Proponents argue that gender responsive budgeting can enhance state responsiveness by ensuring that a careful consideration is made of the implications and impacts of policies, programmes and budgets on women, men, boys and girls belonging to different social groups, when taking decisions regarding public expenditure and revenue generation. Limited empirical evidence, however, exists of the efficacy of gender budget initiatives despite over two decades of implementation. Available literature is also mostly policy- or practitioner-oriented and reported at national level, leaving us in the dark about real impacts at lower levels of government.

Intrigued by the high maternal mortality rates in Uganda and the potential posed by gender responsive budgeting, this study utilises a case of a local-level outside government gender budget initiative in Uganda to investigate the broad question “how and to what extent do local-level outside government gender budget initiatives influence gender responsive maternal health service delivery and the utilisation of skilled maternal health care among rural women?” A sequential exploratory mixed methods approach is applied, which integrates theory-based evaluation with process tracing methods to investigate how and why local-level outside government gender budget initiatives may influence gender responsive maternal health service delivery and the use of services. This is followed by a second quantitative phase, in which a quasi-experiment is conducted to investigate the effects of the local-level outside government gender budget initiative on the demand for gender-responsive maternal health care at household level. Our findings make us more confident than not that the local-level outside government gender budget initiative studied in this case contributed to gender responsive public maternal health care but did not have significant results with regard to utilisation of maternal  health care among rural women. Our findings suggest that gender responsive budgeting should be combined with other maternal health interventions for enhanced results.

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