Focus on a strong, well-resourced health system
In Uganda, we still experience far too many preventable deaths. Maternal mortality is unacceptably high. ...
By Irene Atuhairwe
The COVID-19 total lockdown was somehow an equaliser. The rich, just like the poor could not fly out of the country for advanced treatment and had to settle for what’s available locally and hope for the best.”
This statement was made by a colleague who also happens to be part of the incredible team that successfully conducted an operation on conjoined twins at Soroti Regional Referral Hospital recently.
While she was excited about saving a baby’s life, she also highlighted the challenges that their hospital grapples with. These include a limited number of health workers compared to the patient load, inadequate medical supplies, and poor remuneration.
Her story is not unique. It is synonymous with the stories of many health workers around the country who, despite unfavourable conditions, continue to save lives and improve health outcomes.
While we applaud the team at Soroti and other health facilities for being exemplary, we must remember that applause is not enough. We need to support and invest in the health workforce.
In Uganda, we still experience far too many preventable deaths. Maternal mortality is unacceptably high, for example.
Despite recent improvements in healthcare, according to the Uganda Demographic Health Survey of 2016, about 368 women per 100,000 live births die due to pregnancy and childbirth complications every year.
Although this figure has gone down over the years, no mother should die while bringing life to this world especially since the solutions to prevent or manage complications are well-known.
The situation is the same for other causes of morbidity and mortality in the country, including non-communicable diseases. Whether it is addressing these long-simmering health crises or COVID-19, we cannot nurture progress without a well-resourced health workforce.
Uganda committed to Universal Health Coverage (UHC) by 2030. A realisation of UHC will ensure that everyone has access to the health services they need, when and where they need them, without financial hardship.
To make the commitment a reality requires an equivalent investment in resources and financing. However, let’s look at the 2020/2021 financial year as an example.
The proportion of the national budget allocated to the health sector was a meagre 5.1%. This is way below the Abuja Declaration’s recommendation to African countries to apportion at least 15% of their budget to the health sector.
Currently, the majority of health financing in the country is through development partners and out-of-pocket payments from families—both of which are not sustainable.
One can never know when and where they may need to have a medical procedure or treatment to save their lives or that of a loved one. So many Ugandans sink into poverty while trying to meet the health needs of family members and at times lose the battle.
Decision-makers need to think about this as they approve national budgets and policies that affect our health system.
Nobody is safe from the impact of having a poorly resourced health workforce and health system.
The World Health Organization (WHO) has designated 2021 as the Year of Health and Care Workers in recognition of the role health workers have played in keeping the world safe as we deal with the pandemic.
What is not emphasized enough though is that even before Covid-19, health workers made critical sacrifices and demonstrated enormous courage, skill, and resilience.
At the 73rd World Health Assembly last year, WHO urged member states to invest in health workers’ education, wellbeing, and remuneration among other solutions that will boost their morale, commitment, and retention in the health sector in order to achieve UHC.
On April 7, 2021, World Health Day, the 11th Parliament of Uganda recognized the team from Soroti who in turn called for better pay for health professionals and better-resourced health facilities among other measures.
It is time to respond to WHO’s call to action and listen to health workers— this year provides us with the perfect opportunity to do so.
As budgets and resource allocations are approved, there is a need to critically analyse the resources allocated to the health sector.
It is only through greater investments that we can recruit adequate numbers of health workers, remunerate them appropriately, provide the resources they require to do their jobs, provide appropriate oversight and create a conducive environment for them to work.
Additionally, this will ensure health workers have access to continuous training opportunities to build and sharpen their skills.
Celebrating our health workers is welcome but we cannot stop there.
We must put our money where the applause is in order to strengthen health workers who are fundamental to building the resilient health system that Uganda needs both now and for generations to come.
A strong and well-resourced health workforce benefits all of us.
The writer is the Deputy Country Director, Seed Global Health