Effective public financial management is imperative for the sustainable provision of quality public services. Kampala Central Division faces unique challenges in this domain given its substantial population concentrated within a small area. This study aimed to assess public financial practices at the division and their implications on access to essential social amenities for residents. A mixed methods approach was employed involving document reviews, key informant interviews, focus group discussions and a household survey. Quantitative data was statistically examined using SPSS and STATA while qualitative findings were synthesized thematically. Results indicated that while improvements have occurred, weaknesses persist in revenue generation and expenditure oversight systems. Limited fiscal autonomy owing to narrow tax bases deprives the local administration of adequate funding proportional to needs. Loose controls and insufficient monitoring facilitate resource leakages and misuse undermining ground service availability, equity and efficiency. These governance dysfunctions constrain optimal delivery of services like healthcare, education and water supply as evidenced through accessibility gaps and dissatisfaction levels. The research employed a Pearson correlation coefficient analysis to determine the strength and direction of the linear relationships between each pair of the four factors. A statistically significant strong positive correlation at the 0.01 level was found between fiscal decentralization and revenue generation, with a Pearson's r value of 0.603. This suggested a strong association wherein higher degrees of fiscal autonomy devolved to local administrations are linked to enhanced capacities to mobilize domestic revenues independently. The study concluded that reforming revenue policies, budgets, controls and transparency through technology and stakeholder participation can optimize resource allocation and use to boost residents' access sustainably into the future. Continuous evaluation remains vital to realize financial administration's full potential for improved welfare outcomes.