The true picture of NRM gov't performance in health sector

By Henry Mayega

The history of interventions by the Yoweri Museveni administration in the health sector speak of a sterling performance in Uganda's post-colonial era.  The period under consideration is between1986-2015.

By 1986, all social service sectors, including health, were beginning to look more like an immense pile of filth due to neglect, political instability and sheer national bankruptcy.  The barbarity and incivility of the pre-1986 period had dogged any investment in the health sector and then things began to change with the advent of the Yoweri Museveni administration.

This administration brandished a different set of values - humanity, generosity, tolerance, moral leadership that enabled the setting of priorities.  Now, for some, these interventions are meaningless as those with a cognitive deficit have indicated during the current campaign period. That Abim hospital is not rehabilitated as Dr. Kizza Besigye has intimated is to look at far less than one side of a coin because the less sagacious have completely ignored that majority number of referral hospitals have either been renovated or are under renovation.

The renovated include Mbale, Jinja, Soroti, Moroto, Lira, Gulu, Arua, Mubende, Hoima, Masaka, Fort Portal, Mbarara and Kabale.  Abim Hospital is lined up for renovation.  Like Besigye himself cannot do all renovations at one go at his Kasangati home, the NRM Government has phased out these rehabilitations given the limitedness of the resource envelope to which if, he (Besigye) was requested to contribute more as a responsible tax payer, he could resort to his anarchic walk-to-work antics.  It was an audacious act by the NRM Government in a single motion as well as calculated dexterity to have invested heavily in these renovations which Besigye and his ilk want to visit once every five year cycle afforded to them via campaigns.  These renovations are not drama; they are a calculated move by this administration to uplift the livelihoods of Ugandans.

Secondly, there are vivid examples around Kampala of hospitals either under renovation, have been constructed or under construction. The most vivid example is Mulago referral hospital which is undergoing renovation as well as re-equipping.  No one needs the aid of binoculars or telescopes to see this project.  Coupled with this, this administration sought the construction of hospitals in Nakawa, Makindye and Kawempe divisions to de-congest Mulago hospital.  These are not acts of an insane government, they were prudent interventions aimed at restoring the health system in Uganda.

In the last 30 years, it has been possible given the ablest and radiant leadership and undiminished confidence citizens have for this president to restore the health sector despite challenges like a limited resource envelope, theft of drugs, staff shortages and absenteeism, a lack of nationwide health insurance system, remoteness of some areas (which strains/debilitates government resources because expenditures on medical personnel who work in hard-to-reach areas have to be catered for), etc.  In comparison with what happens elsewhere, say in the US, their health system, despite its robustness, still has issues of coverage, poverty amongst minorities; so nobody should lie to Ugandans that health issues are an exclusive problem of Uganda. Have some of our people, with a cognitive deficit, heard about the "Obama Care" in the US and the level of altercation that policy initiative has visited on that country with regard to who should fund health care there. Have our hair-brained people provided any hybrid alternative options on how health care should be administered?  No.  All you hear are choruses that the health system is in shambles.  Unbelievable!!

Thirdly, such vituperative comments about the health sector are badly squelched and aimed at gaining a political mileage which to me is similar to chasing after the wild goose one will never catch.  This administration, since its inception in 1986, has concerned itself with robust interventions that have ideally, prevented a host of diseases - which are now history.  These include polio, whooping cough, measles, meningitis, influenza, tetanus etc.  Thanks to the construction of 193 Health Centre IVs, 930 Heath Centre IIIs.  The miracle these preventive and curative centres have performed is to uplift the health condition of Ugandans leading to a population increase of up to 38 million people currently from 14 in 1986.  So the preachers of doom have done an injustice to themselves by making arguments whose spinal column is so weak.  By resorting to hospital visits by some, the motivation was to incite staff and the sick; it was just as good that the Government moved fast to stop that hooliganism. The intention was to lit the matches, ignite combustible material and cause a political explosion.

Fourth, there are many other interventions that this administration has made including establishing the National Drug Authority (NDA), National drug stores where all nationally procured medicines are kept and distributed from. Let people also not forget that this administration established Mbarara University of Science and Technology (MUST) to further spur medical profession and facilities.  The liberalisation policy itself (which covers 50% of the delivery of health services) has led to the growth of private hospitals, clinics, pharmacies, drug shops - (let us not forget that these need to be regulated), medical consulting firms, therapeutic and curative measures.  In combination, these interventions have:  burgeoned Uganda's population, reduced infant mortality from 122 in 1986 to 44 currently per 1,000 live births, increased life expectance from 43 years in 1986 to 59 years in 2015. Regarding the distribution of mosquito nets, I saw my church, All Saints, last year urging us to obtain them from established government collection centres.  Ugandans should also remember the sterling performance of this administration in the fight against AIDS which, ideally, brought down not only the incidence of the disease but also its impact on communities.  Have some of our venerable people with less unbounded gratitude heard of mobile clinics now operational in the country.

The reasons for these successes are not difficult to discern; the Ministry of Health developed a strategic plan 2010/11-2019/20 in which the following are being implemented and realized:

•     Continuous health sector investments that have led to improvement of the quality of life (via first Health Sector Strategic Plans I (2000/01-2004/05, II (2005/06—2009/10 and III (2010/11-2014/15).
  
  
•     Development of the National Health Policies NHP) II that covers a ten year period 2010/11-2019/20 taking into account international treaties, the size of our resource envelope, etc.
  
  
•     Establishment of district health systems, health sub-district systems as well as the health centre systems Is, IIs, IIIs and IVs.

In all public health facilities, curative, preventive, rehabilitative and promotive health services are provided pro-homo having abolished user fees in 2001.  The statistics for government owned health centres is staggering:  2,242 health centres, 59 hospitals compared to 613 centres and 46 hospitals owned by Private not for Profit (PNFPs) and 269 health centres and 8eight hospitals purely privately owned.

All these interventions are not from mars, so the bottom is not out of the tub as some would want to suggest.

The writer is the ambassador and deputy Head of Mission in Beijing, China