Budget should consider health for all

Jun 02, 2011

IN the run-up to this year’s national budget day, it is important to reflect on health as a key sector that is lagging behind, but needs resources to iron out specific challenges.

Arthur Rutaroh

IN the run-up to this year’s national budget day, it is important to reflect on health as a key sector that is lagging behind, but needs resources to iron out specific challenges.

Providing health-for-all has become a big global issue today than ever before. The rising health care costs and premiums make it difficult for many to have access to quality and comprehensive health care services.

In Uganda, health concerns continue to be a priority.

Given the diversity of the health care needs of the population across the board, the demand for a functioning, accessible and efficient health care system continue to dominate Ugandans’ expectations.

After the abolition of user fees in 2001 as one of the sector reforms, it was hoped that all Ugandans would have free access to health care services. However, over the years, utilisation has swerved back and forth. Drug stockouts, insufficient funding, dilapidated health facilities, a de-motivated workforce among others continue to emerge as the major challenges affecting the efficient delivery of health care.

On March 15, the New Vision reported a nurse who was arrested for stealing government drugs and selling them in his private clinic, such stories abound to date and are a sign the health sector is ailing.

To address these challenges, there is need for a systematic assessment and corrective measures that will iron out irregularities in the health sector so as to promote efficiency.

Uganda’s performance on health indicators from a global scale remains average compared to other countries. Uganda’s population, for example, is currently estimated to be 32.2 million with a fertility rate of 6.7 and a growth rate of 3.2%.

Such population increase puts high demand and pressure on the health care system and makes the need for universal health coverage more crucial than ever before.
Although, Uganda has made progress in improving the health of its population and life expectancy has increased from 45 years in 2003 to 52 years in 2008, malaria, malnutrition, respiratory tract infections, HIV/AIDS, tuberculosis and peri-natal and neonatal conditions still remain.
These conditions are leading causes of morbidity and mortality, but are preventable and can be avoided at the same time.

Globally, inadequate funding to meet the health care needs of citizens is underlined as one of the key challenges which impedes service delivery.

The failure by countries to make health a priority in their budget allocations, which is the case for Uganda needs to be urgently addressed. This has been evident especially where the biggest percentage of funding for the health sectors is coming from foreign donations.

Despite this challenge, health care financing remains high on the international policy agenda, with calls by the 2005 World Health Assembly to pursue social health insurance and other pre-payment methods of financing health services in order to achieve universal access to health care, an option Uganda should seriously pursue. It is, therefore, increasingly becoming a global concern that universal health coverage is pursued and prioritised by countries across the globe.

Successful achievement of universal coverage will require ensuring equitable health care financing policies, health insurance for all and addressing the problems of health workers. To attain universal coverage, issues of inefficiency in the management of health services, measuring and learning from health outcomes and paying attention to the micro and macroeconomics concerns is critical.

It is also important to focus on community participation and prioritise behavioural and operational health research if the sector is to transform for good. All these must be interlinked to inform the process of health care delivery, which are not properly aligned and systematically coordinated by the health sector at the moment.

The Government needs to negotiate the future through not only taking courageous and creative technical decisions, but ensuring political will around the desired future for the health care system.

Universal coverage can be achieved, but the country needs professional think tanks that will continuously engage politicians and technocrats to think through the methodologies they use to communicate and make informed choices on health.

To improve health care in Uganda politicians and policy makers need to prioritise the health sector in the upcoming budget. In addition, policy makers should pay special attention to the problems affecting the sector.

What has been noticed in the recent heated debates of the political campaigns, is the optimism that all politicians are concerned about health care in Uganda.

Ugandans should hold the Government accountable for whatever happens.

It is in their interest to demand for information and know their role in the process of universal health. Yes, Uganda can achieve universal health coverage.

Health systems and media consultant

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