Uganda SDS Project: CLA Case Study

This is an in-depth case study of the Strengthening Decentralization for Sustainability (SDS) project from Uganda. SDS is a hybrid project addressing health, HIV, and governance. SDS was one of the very earliest projects to attempt large-scale integration of local governance capacity-building work into a sectoral service delivery initiative. SDS also demonstrated USAID’s emerging concern for coordination of different streams of US development assistance at the local level, and its interest in working directly through local systems – principally by means of direct grants to sub-national governments and hands-on technical assistance. In many ways, SDS was a forerunner of several later large-scale sectoral service delivery projects in Africa and Asia funded by USAID that sought to provide significant institutional strengthening assistance at the local government level, along with coordination anchorage. However, unlike most of these later projects, SDS was designed and managed by a health team at USAID, not a democracy and governance team—which had important implications for the project’s evolution, focus, and achievements. 

Although ostensibly a health project, SDS had an unusual focus on decentralized capacity-building. Efforts of this kind are now frequently anchored in local government support projects managed by a DRG team (though they have increasingly been financed through USAID health and other sectoral teams with larger funding streams). For a health team to champion local institutional strengthening was itself innovative, but there were several individual capacity-strengthening interventions that broke new ground as well. First, SDS provided direct performance-based financial support to local governments, relying on local systems and accounts. Second, the project directed TA to local governments based on individualized organizational capacity assessments, which were new at the time. Third, it assisted those governments to coordinate and monitor the health and social services initiatives being carried out by donor-funded IPs. All of these pillars were designed to enhance district ownership and autonomy that could help sustain service delivery improvements. In this sense, it was one of a handful of early projects that advanced USAID’s efforts to integrate governance work into sectoral service delivery initiatives.

But SDS was never entirely clear about the causal pathways by which district capacity-building would translate into better health service delivery—or about how the former would be balanced with the latter in terms of effort and funding. And the design team failed to ground its work in any rigorous political economy analysis (PEA) of Uganda’s overall local government context or particular power dynamics in the core 35 districts. There was, moreover, little coordination at the design stage, or thereafter, between the health and DRG teams—something that is now becoming more routine due to the efforts of USAID’s DRG Center and its 2016 dissemination of cross-sectoral integration case studies. Better coordination might have resulted in a more realistic scope, more sustained capacity-building, and a more robust set of demand-side activities (SDS was unable to engage meaningfully with local political figures (local councils) or CSOs/CBOs, which made it more difficult to empower on the demand side some of the mechanisms of accountability it was pledged to strengthen on the supply side).

The synergistic project components discussed here comprise what might be termed an ‘SDS Model’ of local government capacity-building. This approach demonstrated significant promise in working toward an improved culture of accountability and commitment to results in several discrete health and social services arenas. This incremental progress represented a significant accomplishment in a Ugandan political environment of partial decentralization that severely constrains district resources and freedom of maneuver. But full application of the SDS model in practice proved impossible. First, the model did not have sufficient time to generate more robust results; start-up difficulties and later mid-stream programming changes and budget cuts effectively limited the project’s core capacity-building work to no more than 2 ½-3 years.

Second, the project’s trajectory reflected difficulties typically encountered by large, ambitious local institutional strengthening and service delivery support programs that operate in challenging environments but may not be anchored in a governance design that closely meshes with existing political realities. To this day, USAID often pursues such interventions as a matter of bureaucratic convenience – addressing multiple CDCS priorities and signaling serious engagement – even when a proper PEA would highlight unrealistic assumptions about local capacity and the speed of local TA uptake. These projects frequently allow insufficient time for work plan development and baseline data collection for M&E activities, and do not adequately ‘go with the grain’ in cultivating central and local political leaders, CSOs and CBOs). This was true of SDS, where a health team’s otherwise strong grasp of basic local governance problems in the country ran up against a lack of governance programming experience--and inadequate early consultations or coordination with the Mission’s DRG Team, which designed its own local government program, albeit largely in complementary districts (That program—the Governance, Accountability, Participation and Performance (GAPP) Activity—has also sought to strengthen local government capacity to support improved service delivery, but with a stronger emphasis on central government oversight and community monitoring of services; while  the GAPP approach has shown promise in incrementally improving accountability, it too has tended to spread its capacity-building work too thinly across dozens of districts and has notably lacked SDS’  urgent, applied focus on specific sectoral service delivery priorities). 

Finally, SDS fell victim to its own success. As it innovated, achieved, and demonstrated its flexibility as a successful platform, it attracted higher-level interest in the Mission. This resulted in the project’s assuming the DOP work, as well as the later HRH, primary reading, and WASH activities. Such disparate, high-visibility demands discouraged reflection and learning, which might otherwise have led to stronger, more sustainable results consistent with the original capacity-building focus.