Report: Uganda's Health Service Still Deficient

2209 Views Kampala, Uganda

In short
Access to basic healthcare in Uganda is still limited and the quality remains low caused by poor health infrastructure across the country, a new study by the Economic Policy Research Centre EPRC says.

 Access to basic healthcare in Uganda is still limited and the quality remains low caused by poor health infrastructure across the country.
A new study by the Economic Policy Research Centre (EPRC) says there still infrastructure and human resource gaps impeding Uganda from realising Universal Health Coverage (UHC).
Health experts define UHC as the availability of quality and affordable health services for all when needed without financial hardships, noting that this can be a vehicle for improving equity in healthcare.
The report is compiled by Francis Mwesigye, a Research Fellow and Tonny Odokonyero, a Research Analyst at the Economic Policy Research Centre.
They found that the low quality of healthcare has also been caused by sub-optimal operation of health facilities, and staff absenteeism, among others.
The study results show spatial inequality in health facility/population coverage and private sector health infrastructure investments. Odokonyero in an interview says low health workforce density is widespread across the country.
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The study also reveals that the health services in the country will remain poor even if the staffing levels in the public hospitals  is raised to 100% as per the set staffing norms for critical cadres.
In other words, the health workforce density will still fall short of the recommended standards.

Odokonyero says the low health workforce density implies that the existing health workforce is deficient and unable to expand population-based healthcare services.
The study found that across regions, health facility density ranges between 11.32 per 100,000 people in Eastern region to 21.71 per 100,000 people in central region.
Accordingly to the study, 41% of women in reproductive age reported that they have a serious problem in accessing healthcare for themselves when they are sick due to distances to health facilities.
The problem is more striking in the South-Western and Northern regions as well as in rural areas and amongst the poorest.
It says the health facility population coverage is lowest in Eastern and Northern Uganda when compared to the rest of the regions. The distribution of health facilities according to the report is skewed, in favour of the Central and Western regions.
Majority of the facilities are established in the Central region at 39% - including clinics and 33% - without clinics. The private for Profit (PFP) health facilities are more common in the central representing 30% of all facilities followed by Western region with 8.7%.
There is marginal private sector investment in health facilities in the Northern and Eastern regions, given that PFPs (clinics) account for only 3.2% and 3.7% of all health facilities respectively.
Results of the study show some improvement in public sector staffing reflected by reduction in staffing gaps at all health facility levels between 2008 and 2013. About 52 and 56% of the required human resources for health positions are filled for general staffing for both non-medical and medical.
The World Health Organization recommends 2.28 health workers per 1,000 people but the results show that the health workforce density for Uganda ranges between 0.46 and 0.54 and varies across regions.
This according to the study means that the existing health workforce in Uganda's public health sector is deficient and unable to expand population-based healthcare services. That poses a serious threat towards Universal health coverage progress.
Universal health coverage has been one of the most prominent goals under the 2030 sustainable development framework, catapulting even the world's most influential leaders, the G7, to reference it during their recent high-level meeting in Hamburg, Germany.
Reviewing current staffing norm, the report says that recruiting health workers and staff retention initiatives are critical in achieving the WHO recommended standard.
The EPRC study did not focus on how much resources are needed to treat Uganda's deficient health system. Odokonyero told URN that other studies are underway to focus on financing for health. But he says what it will take to reach Universal health coverage (UHC) depends on a number of factors.
These include generating significant resources to build the necessary infrastructure - such as hospitals and clinics - the tools and diagnostics for proper health assessment and treatment, and increase the number of health workers among others.
Placing a figure on how much is actually required is complex, given the uncertainties such as government's stability, ability and willingness to invest in the health sector, as well as future price changes on everything from medication to infrastructure.