Medics urged on embracing healthcare integration

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The health ministry has urged health workers to embrace healthcare integration of services in all government hospitals.

Ministry permanent secretary Diana Atwine made the call during the closure of a high-level stakeholders meeting on February 18, 2025, at the Imperial Royale Hotel in Kampala.

The call comes one week after the closure of all independent HIV clinics by the health ministry and the integration of HIV services with the general outpatient.

According to Atwine, patients will now receive 'good and quality services', especially people living with HIV, because some of these clinics had designated some days for work, which left many patients unattended to if they failed to make it on the designated day.

NCD high-level stakeholders pose for a group photo with the permant secretary Diana Atwine on February 18th 2025 at Imperial Royalle in Kampala. (Photo by John Musenze)

“During my tours, I found a woman living with HIV and at the same time had hypertension; unfortunately, all these conditions had different days, and she could come to the hospital like three times for services because she could not get the services at the same time. This must and will stop with this integration,” she said.

“When I recently announced this change, people wanted to take to the streets. Then I had to explain myself. But integration is the way to go," she added.

According to her, with limited resources and a big burden of diseases, there is no way 'they can just work inside of us': “It’s not possible. We are not going to achieve much, yet we know that in integration, there is a benefit”.

Prevention is the way

Uganda’s NCD [non-communicable disease] burden is increasingly rising, according to Atwine, but the best way to handle this is by putting emphasis only on prevention.

"I think our emphasis should really be on prevention because the burden is big. How many people? How many beds are we going to create? How many hospitals for the future? How will we manage the chronicity of these cases and the cost, which is very expensive?" she said.

Occupational health safety

Atwine also addressed the challenges posed by occupational health hazards, sharing a concerning observation from a recent hospital visit in Mubende district.

"I visited a hospital... and I found a lot of pneumoconiosis cases... people who are mining in those mines of gold."

She said this revelation highlighted the urgent need for enforcing occupational health safety standards, especially in the burgeoning mining sector, to prevent work-related respiratory diseases.

She advocated for a clear and actionable prevention strategy, focusing on community-level interventions and health education to curb the incidence of NCDs.

Financial challenges

Department of Physiology at Makerere University chairperson and a renowned kidney and hypertension specialist Dr Robert Kalyesubula provided an in-depth analysis of the financial challenges in managing NCDs.

Dr. Robert Kalyesubula, Chairperson of the Department of Physiology at Makerere University and a renowned kidney and hypertension specialist. (Photo by John Musenze)

He pointed out the stark contrast in budget allocations, noting, "In Rwanda, the budget allocation for health is about 18%, and 3% was for NCDs... Here... the Ministry of Health... had only 50 million in the budget for non-communicable diseases," Kalyesubula said.

This disparity underscores the pressing need for increased funding and resource allocation to effectively combat NCDs in Uganda.

Both speakers highlighted the significance of integrating NCD care with existing infectious disease programmes. Atwine highlighted the benefits of such integration, stating that it leads to better patient outcomes due to shared resources and comprehensive care approaches.

Kalyesubula echoed this sentiment, advocating for a holistic approach where "if a patient presents with infections, look for non-communicable diseases. If they come with non-communicable diseases, make sure that they don't have an infection."

The two-day event brought together experts, policymakers, and healthcare professionals dedicated to formulating a comprehensive strategy to combat NCDs nationwide, focusing on addressing the escalating burden of non-communicable diseases (NCDs) in Uganda.