Health budget increased, but..

Jun 19, 2013

The status of a country’s health sector is undoubtedly one of the core yardsticks upon which its overall growth and development is judged. However, Uganda’s budgetary allocation towards the health sector has been fluctuating, at least in the past four financial years.

By Chris Kiwawulo

The status of a country’s health sector is undoubtedly one of the core yardsticks upon which its overall growth and development is judged. However, Uganda’s budgetary allocation towards the health sector has been fluctuating, at least in the past four financial years.

Whereas health activists have, for long, been advocating for a continuous increase in the health sector budget, it has been inconsistent. Besides, the health budget has, for many years, been falling short of the 15% Abuja Declaration target. Heads of state of African Union countries, including President Yoweri Museveni, set the target in April 2001.

In the financial year (2013/14), the health sector has received sh940b, up from sh852b in 2012/13. This means the sector has received about 7.2% of the national budget of sh13.1 trillion, which is still below the 15% target. Last year, the health sector got about 7.6%, while in 2011/12, it got slightly over 8%.

In 2010/11, the allocation to health was sh660b and it leaped to sh985.58b in the subsequent year (2011/12). However, the drop by sh133.58b in the following year (2012/13) to sh852b left many health activists’ tongues wagging.

The Government would have reduced it further by another sh52b to go to the defence ministry had it not been for the intervention of MPs. They argued that more funding was needed to cater for an increase in the number of medics and their pay.

Since it was the Government that had promised to recruit more health workers and increase their salary, the decision makers realised that reducing the budgetary allocation to health would be shooting their own foot.

Indeed, finance minister Maria Kiwanuka, while reading the budget on Thursday, announced that last financial year (2012/13) has seen the Government recruit 6,172 health workers and double the monthly pay for doctors at health centre IVs from sh1.2m to sh2.5m.

However, the concern of Dr. Lulume Bayigga, the shadow health minister, is that the budget allocated to the health sector is not usually released wholly. “Most of the budget allocations are released up to 55% with some as low as 35%,” he observed, adding that this makes it difficult to deliver health services.

Bayigga added that corruption during the implementation of the health budget at the grassroots was making it hard for the sector to register progress.

“Our capability as MPs to monitor the implementation is also compromised by lack of time and enough resources to do our work.”

Although MPs pushed for increased funding and the World Bank agreed to give Uganda a loan of $130m (sh338b), Bayigga said most of the money is swapped for other projects.

“For instance, rehabilitation of Kawolo Hospital was budgeted for about five years ago under the World Bank health sector strengthening plan, but no work has been done to date, and the condition of regional referral hospitals is appalling,” he pointed out.

But the finance minister said the Government has plans to construct and equip regional referral hospitals. She said the Japan-funded Kabale and Hoima regional referral hospitals reconstruction and equipping was complete, while procurement is underway for contractors to renovate Mulago Hospital and construct hospitals in Kirudu and Kawempe.

“The Government will focus on immunisation, equipping health facilities such as Uganda Heart Institute, Uganda Cancer Institute and Uganda Blood Transfusion Services, as well as recruitment of key health workers in order to increase delivery of maternal and child health care services,” said Kiwanuka.

She noted that the vaccine against pneumonia (PCV) that was launched in April, 2013, with support of the Global Alliance for Vaccines Initiative, and immunisation campaigns were conducted and are still ongoing in 49 districts.

Kiwanuka also said funding of housing for health workers with special attention on under-served areas, drafting of laws to establish the national health insurance scheme will be given priority.

“Governance and efficiency in health service delivery through increased joint supervision and monitoring in collaboration with non-governmental health institutions will also be a government priority next year,” she added.

The Government also committed itself towards developing and implementing a comprehensive strategy to eradicate malaria and strengthen its prevention, diagnosis and treatment. It also committed itself to reduce morbidity and mortality from the major causes of ill health and premature death.

With more funding towards the health sector and the Government pledging to fulfill its obligations next financial year, a lot more is expected to improve the sector.
 

 

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