This policy brief explores the relationship between accountability and SHP, and its implications for PHC implementation in Uganda. It draws on a qualitative case study conducted in four districts, analysing real-world practices in provider payment, fund flows, performance monitoring, benefit package design, and citizen feedback. The study was conducted by Makerere University School of Public Health, in collaboration with the Ministry of Health, through the Strategic Purchasing Africa Resource Centre (SPARC), implemented by Amref Health Africa. The findings aim to strengthen priority interventions in Uganda and other Low- and Middle-Income Countries (LMICs) as they strive to make progress towards the realisation of Universal Health Coverage goals.