Invest in preventive rather than curative health care, Makerere don asks

PIC Thomas Tiedemann and Sarah Opendi sign some copies of the universal health coverage book after its launch at the Kampala Serena Hotel Kampala on Thursday. Photo by Juliet Kasirye

HEALTH CARE

If Uganda is to achieve the Universal Health Coverage (UHC), more investment needs to be done on strengthening systems that promote good health, especially at community level, Prof Freddie Ssengooba, a lecturer of health economics and health systems management at Makerere University has said.

Statistics indicate that the proportion of the national budget that is spent on the health sector has been declining over the years from 9.7% in 2004/05 to 6.4% 2015/16.

Speaking during the during the launch of a book on universal health coverage titled "Universal Health Coverage in Uganda: Looking Back and Forward to Speed up the Progress", Ssengooba, the lead editor explained that the cost-effective road map to UHC should entail beating down pervasive causes of ill-health and related social and economic losses to the country.

However, the don said scaling up interventions to eliminate unwanted pregnancies and diseases such as malaria, diarrhoea and childhood illnesses are important.

"Relatedly, health expenditures attributed to non-communicable diseases can also be saved by promoting community actions and lifestyles that reduce obesity, smoking and similar behaviour," Ssengooba said.

The book put together by over 30 authors with expertise in health policy, planning and economics is a product of the Supporting Policy Engagements for Evidence-based Decisions (SPEED) project funded by the European Union. It also captures the status of universal health coverage readiness and generates policy advice cognizant of the health sector developments in the last 10 to 15 years.

"The agenda for health system strengthening and resilience has been narrowed to fixing the gaps at health centres to deliver treatment for the sick. However, fewer investments have gone to systems that promote good health at community level, yet accelerated attainment of good health and well-being requires expanding the community systems for health promotion, good nutrition, progressive lifestyles, and surveillance and response to health risks," Ssengooba stated.

In Uganda as discussed in the book, 75% of the disease burden is preventable, and yet, there is high expenditure on the medicines, which turns the focus to cure as opposed to prevention.

"It is not acceptable that some members of society should face death, disability, ill-health or impoverishment for reasons that could be addressed at limited cost." the book states.

With the Government efforts to operationalise the National Health Insurance Scheme (NHIS) still barely taking shape, the authors recommend the inclusion of the poor and the vulnerable from the start.

The experts also recommend leveraging the already existing social security mechanisms, such as the National Social Security Fund (NSSF) and microfinance schemes, as innovative mechanisms to pool resources and guarantee access to health care for its members.

 

Speaking to several stakeholders, the state minister for health, Sarah Opendi Achieng, said the book launch was a huge contribution to the health sector adding that evidence is needed to make decisions on the policy direction to take.

"This book provides an in-depth understanding of the policy trade-offs, especially in resource constrained countries such as Uganda. It also provides useful advice on how to expand the fiscal space for health while leveraging health benefits from other sectors of the economy and ways to manage the rapidly growing population and the health needs thereof," Opendi said.

Thomas Tiedemann, the acting head of co-operation at the European Union, called upon the Government to make the necessary investment in the health sector saying the focus on policy and innovation is one of the biggest strengths of the book launch.

 "I may be fortunate enough to be able to pay for the services of private sector health care services, but many Ugandans are not fortunate enough. It pains me to hear of drug stock outs or lack of oxygen in health facilities for respirational or critically ill patients," Tiedemann said.

"We are very aware that health is not health care alone, and therefore, there is need to include other determinants of health such as nutrition, sanitation, transport, among others," he added.

Prof. William Bazeyo, the Makerere University deputy vice-chancellor in charge of finance and administration, said despite the problems the university faces, it continues to rank second best in Africa due to its research. He called on Government to fund them.

"Of all the research that is published at the university, 80% comes from the college of health sciences, 99% of which is funded by donors. Just imagine what it would be like, if we got more funding from Government," Bazeyo said, adding that the university was positioning itself to become a research driven institute.