This paper investigates the causal pathways through which chronic fiscal indiscipline has precipitated the systemic collapse of public
services in Uganda over the period 2000-2023. Combining a synthetic-control fiscal shock analysis with an original service-delivery
scorecard covering 2,400 sub-counties, we estimate that every 1 percentage-point increase in the structural primary deficit is
associated with a 0.78-point deterioration in an aggregate Public Service Performance Index (PSPI). Disaggregated results reveal
that health and water services have contracted most severely (-1.13 and -0.97 PSPI points respectively), while education outcomes
have stagnated despite rising enrolments. Event-study estimates around three major shocks—(i) the 2006 election-cycle spending
surge, (ii) the 2011 oil-boom borrowing spree, and (iii) the 2020 COVID-19 emergency disbursements—show that non-concessional
debt crowds out pro-poor recurrent budgets within four quarters, with effects persisting for at least five years. Qualitative evidence
from 147 key-informant interviews across 18 districts corroborates the quantitative findings: frontline providers report chronic stock-
outs of essential medicines, delayed teacher salaries, and collapsing rural road networks directly linked to arrears accumulation and
off-budget expenditures. Finally, we simulate the counterfactual impact of enforcing a constitutional debt-limit rule coupled with a
medium-term expenditure framework; the results indicate that Uganda could have averted 38 % of the observed decline in service
delivery and reduced extreme-poverty headcount by 4.2 percentage points. The paper concludes with politically feasible institutional
reforms—anchored on transparent oil-revenue earmarking and an independent fiscal council—to break the cycle of fiscal profligacy
and revive equitable public services.