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Government urged on health financing, staffing in rural areas

By Lillian Namusoke Magezi

Added 13th September 2019 04:23 PM

Researchers made recommendations while presenting policy papers on health in Kampala recently.

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Mulago National Referral Hospital. (File Photo)

Researchers made recommendations while presenting policy papers on health in Kampala recently.


KAMPALA - As Uganda works towards achieving Universal Health Coverage(UHC) and wellbeing of all its citizens, researchers at Makerere University have made key recommendations in regards to financing and human resources for health (staffing). 

The researchers made recommendations while presenting papers in Kampala recently.

One of the researchers Esther Namugoji noted that when it comes to human resources for health, one of the key recommendations is the motivation of health workers in rural areas to improve their attraction, recruitment and retention.

Esther Namugoji said the World Health Organisation recognizes four categories of actions that could be taken to motivate staff. 

Namugoji, who works at Parliament’s department of research services, listed the actions as education, regulatory, financial incentives plus personal and professional support.

Presenting a paper titled Rural Staffing in the Health Sector: Attraction and Retention Options for Uganda, Namugoji noted that a shortage of health workers in rural areas is a setback to universal health coverage goals. 

“This is because the majority of Ugandans (75%) live in rural areas, but the majority of health workers are employed in urban areas, therefore, the health needs of people in rural areas are not adequately met,” she said

In this regard, Namugoji urged Government to target incentives on staff who already work in rural/ hard-to-reach areas and show willingness to stay, implement staff performance management mechanisms so as to reduce absenteeism and general workplace indiscipline and ensure reward and recognition for existing staff for their efforts.

Health financing

When it comes to health financing, Richard Ssempala also a researcher decried the low public funding to the health sector (15.7%) with private sources (42.6%) and donors contributing much more. 

Ssempala while presenting a paper titled Health Sector Budgetary Allocations and their Implications on Health Service Delivery and UHC in Uganda. Ssempala analysed health sector budgetary allocations and their implications on health service delivery and UHC in Uganda.

He explained that the insufficient budget impacts the quality and quantity of health services provided as characterized by recurrent drug stock-outs, low staffing levels and poor infrastructure.   

Ssempala recommended a substantial and sustained increase in the government’s health budget. 

He also called for optimization of the available resources by addressing wastages, prioritizing health promotion, prevention and early interventions.

In addition, Ssempala recommended that the country’s fast-growing population be controlled and the national health insurance scheme be institutionalized.

On the other hand, Dr. Aloysius Ssennyonjo’s paper was titled National Health Insurance in Uganda: Examining the Proposed Design and its Implications for Successful implementation.

After assessing the pros and cons of the proposed designs, Ssennyonjo recommended progressive sequencing of the national health insurance scheme starting with focusing on improving the supply of health services and building the purchasing function. 

Another recommendation was providing the public with an explicit entitlement and expect them to pay later.

He noted that generally, the provision of health services has been hindered by a big informal sector, high population growth, inequalities and inequities in the country and paying at the point of accessing care.

About the research

The three researchers carried out their studies under the ReBUILD Research Consortium, a six-year (2011-2016) research partnership that was implemented in four post-conflict settings.

In Uganda, the project was focused on the Northern Uganda districts of Gulu, Kitgum and Amuru. 

The research Was led by Makerere University School of Public Health and the School of Women and Gender Studies.

ReBUILD research work was conducted in the two broad areas of health financing (aid management and effectiveness, and household health expenditures) and human resources for health (human resource policies, motivation, incentives and coping mechanisms).

In its second phase of implementation, ReBUILD in Uganda had a fellowship exchange with the Research Services Department of the Parliament of Uganda. 

The exchange involved two staff from Parliament and one staff of Makerere University School of Public Health. 

As part of the fellowship, the fellows had hands-on experience with policy analysis during which they worked on and produced policy papers focused on different health policy issues.  

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