The ultimate question to ourselves is whether the health system of Uganda is really coping up with the different emerging infectious diseases and really what can be done to improve on the health issue that is at the point on collapsing the healthy system.
Uganda is one of those countries that have embraced the decentralised system of health administration. It has public, private and even the traditional and complementary medicine practitioners providing the health services to the public.
At the beginning of the 21st century, the country had started actually implementing the health sector reforms of which in the first place were aimed at improving the health delivery and coverage of the health service system to the community. These included a Sector wide approach (SWAp) in 2001, user fees in 2001 and decentralization in 1990s that was sealed in the 2000s.
To ensure proper service delivery especially in terms of the medicine delivery, there was a pull system that was introduced where by the medicines and health service delivery were mainly demanded to the lower sectors of the health chain which actually improved on the service delivery since many people in the population were able to get the medication and the treatment services at their local areas. Later in 2011, a comprehensive health building blocks of 6 were introduced to manage the weakness that had been identified in the system.
However, the recent years have proven how weak and unprepared our health system is with a lot of high disease burden from diseases like malaria, diarrhoea, child deaths and maternal health issues. This can also be observed from the recent pandemic of COVID19 where there was a lot of people dying everyday yet simple and strategic measures were in place but somehow the implementation became a very big challenge to the system.
Below are some of the important analysed issues that could be affecting the readiness of the health sector in managing the different health issues.
Health financing
- It has been of recent that the government of Uganda has tried to improve on the money allowance that is being channeled to the sector but over the years, the army and other sectors have been funded more than the health sector. This has left many health faculties with little or no required equipment such as the machines required in the scanning of some of the Non-communicable diseases like Cancer. Actually, this has been a problem even in treatment and management as many people have to travel from very districts to the city centre to get the required treatment and in the end many of these die to the health condition.
- Limited funding also makes it hard for the sector to procure the required medications and thus affecting the medicine availability in the health facility which has actually made a lot of people stop going to the health facilities. On the hand, the NGOs have in a way been so helpful as many of these government health facilities have been funded by different Ngo projects that have availed the required equipment or even medicines required.
Health workforce
- Uganda has of the recent had a very crumbling workforce. This has been attributed mainly to the poor wages and salaries offered to them which has made many of them over the years to actually leave the country in pursuit for the better paying jobs and other have actually gotten into the different fields such as social sciences and research other than their practice with the aim of getting better pay. This the end will limit on the task force needed to meet the needs of the public. During COVID19 for example, the initial stages had a lot of issues as many of the health workers were no motivated to work and in so doing the cases over the time increased and later the number of people that were dying also increased. But however, after the introduction of the health worker motivation in terms of allowances, there was a transition as many of the health workers involved themselves in the practices of prevention the pandemic such vaccinations and even testing and education.
- On the other hand, the health workers professions have been adulterated with the larger number of poor qualified health professionals being produced from the universities and other higher learning institutions which in the end has increased in the number of people in the profession who actually do not have an idea on what to be done. This limits the productivity of the members since these people actually will do nothing but rather than the take the profession slowly.
- The divisions in the health workers professionals is also a very vital point to this concern. There are a series of health bodies ranging from the Uganda medical association up to the environmental health association who are actually vital front liners in the prevention of diseases. The dominance by the clinical and other bodies has in a way made the other field to be left aside and thus leaving a very big gap that need to be actually covered.
Policy and poor implementation
- The policies that are actually formulated in the country to manage the development of the health sector have actually been not implemented by the different stake holder. Policies are actually made to solve particular issues or pass particular issues but due to the poor implementation by the people in offices, this leaves a very big gap as there will exist a lot of pending issues that actually need attention but have not been addressed.
Corruption
- This is one of the most causes of the down fall of the health profession as many people in the sector have opted to be corrupt rather than to execute their duties as the health professionals. This in the means that a lot of things will be waivered than being corrected. This is seen clearly among the drug /medication system where a lot of drugs are being taken into the private health facilities as the government officials are given a bribe to sell them their and in the end there is a big gap when it comes to the drug availability which in the end forces the public to lose trust in the system and also limited coverage in terms of the health service deliver.
Note:
If the health sector of Uganda has to be changed, there is a set of issues that need to be done ranging from the financing and capacity building of the health workers though the different training and conferences, use if the evidence based research to manage the different health conditions, improved training and regulation of the health schools so that the students produced from these institution are capable and competent in working in the health facilities, developing of policies like the health policies that limits the number of people leaving the country, increasing on the funding of the sector in terms of salaries and wages for the different health workers. Close regulation of the sector so as to identify the short falls and then evaluate what to be done.
This in the end will guide and help to improve the health sector so that its able to manage the different occurring disease outbreaks and other re-emerging zoonotic diseases.
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