Uganda on path to universal health coverage

By Jacky Achan

It is not uncommon in Uganda to hear, see or read in news reports that a patient has been detained by a health facility over failure to clear their medical bills when they seek quality healthcare.

But "good health is the foundation of a country's human capital and no country can afford low-quality or unsafe healthcare," according to World Bank Group president Jim Yong Kim. Therefore, when patients get detained or fail to get quality healthcare due to costs, it leaves many questions unanswered.

In this case, why can't Ugandans, especially the less fortunate ones, afford quality healthcare? What is Uganda doing in this regard? On Sunday, Uganda joined the rest of the world to celebrate World Health Day.

This year, just like last year, the theme was Universal health coverage: everyone, everywhere. So, what efforts has Uganda made towards universal health coverage? Tracing it back to 1987, with the advent of the liberalisation policy, the private sector was allowed to partner with the public sector to provide health services.

The public-private partnership ensured there was a diverse range of health service providers, which boosted access to health facilities by the population. In the same year, the decentralisation policy followed.

In the 1995 Constitution and the 1997 Local Government Act, local authorities were allowed to participate in health service delivery.

This was in addition to recruitment and management of personnel for district health services, passing by-laws, budgeting, plus additional resource mobilisation and allocation for health services. User fees were also introduced in health facilities at the district level.

The likely outcome of this was the exclusion of the underprivileged from accessing health resource. Luckily, from the financial years 1999/2000 to 2009/10, Uganda implemented its first National Health Policy.

The objective was to reduce mortality, morbidity and fertility, plus the gaps therein through ensuring that people have access to a minimum healthcare package. CLICK HERE FOR MORE ON THIS STORY 

How to achieve health for all

April 7 was World Health Day. The focus this year is on universal health access. The World Health Organisation country representative in Uganda, Dr Yonas Tegegn Woldemariam, in an interview with Geoffrey Mutegeki says the vision is achievable and sets out how it can be done

The tagline for World Health Day is: "Health for all — everyone, everywhere". What does this mean?

"Health for all — everyone, everywhere" is a movement to highlight our goal of achieving a fairer, healthier world, in which no one is left behind. The focus is not on just attaining better health, but also addressing gaps in access to ensure that good health is not a privilege for a few, but is enjoyed by everyone.

What are the aims of this health for all campaign?

This campaign aims at bringing onboard decision makers at all levels to commit to taking action to address gaps in universal health coverage in their countries, as well as to highlight progress that countries have made.

When we talk of health for all, what services and support should be available and where?

The range of services, such preventive, promotive, curative and rehabilitative to be delivered should be that which addresses the priority conditions that contribute the highest burden of disease across the population. The services provided need to be responsive to the population needs. In an efficient, well-run health system, there needs to be a clear referral system, starting with the basic primary care to specialised services 

How can health for all be made possible in developing countries like Uganda which still struggle with funding their health system?

Achieving universal health coverage is possible even in countries like Uganda. The lessons we have learnt from countries which have made progress towards universal healthcare is that they have prioritised primary health care. The starting point is ensuring that the health system addresses prevention, early detection and then build unto that, ensuring that there is capacity to treat and rehabilitate patients. While the latter requires investment, even then we could prioritise the interventions that are most effective to address our disease burden and deliver these efficiently. CLICK HERE  FOR MORE ON THIS INTERVIEW 

ProFam: Improving access to reproductive health services

By Agnes Kyotalengerire

It is a Saturday morning, but Florence Aguti Okia does not have the luxury of staying at home to probably sleep a little longer. As early as 8:00am, St. Martha Maternity Home in Kacumbala trading centre, Bukedea district, is packed with women.

Some have come here to deliver, while others want contraceptives. After about an hour of doing rounds in the maternity ward, Okia inally settles down to attend to a long queue of women who have come for consultation on family planning methods.

Some have no idea about the different types of contraceptives, so she explains how the different methods work, before they can make a choice. Others, who are already using contraceptives, have come to receive their next dose.

According to Okia, there is a remarkable improvement in the number of women seeking sexual reproductive health services. Okia attributes the signiicant improvement to the training and continuous support from Population Services International (PSI) Uganda.

PSI is a not-for-proit organisation with a hand in providing sexual and reproductive health services for women. The PSI country representative, Dr Dorothy Balaba, says the primary focus is to ensure that women and couples can easily access reproductive health services and commodities of their choice free of coercion or discrimination.

Filling the gaps
The 2016 Uganda Demographic Health Survey indicates that the unmet need for family planning is still high (28% in 2016). The same report indicates that often, lack of contraceptive methods of choice is a factor that hinders some women from embracing family planning.

Balaba says PSI Uganda has spread its wings across the country. Currently, they operate in 87 districts and work with private service providers to ensure that women access quality reproductive health services at their doorstep.

"We are trying to innovate around the private sector, working with private health facilities in the communities. We franchise them to ensure high quality reproductive health services at every point so that women do not miss the opportunity," Balaba says. She adds that they work with the facilities, brand them as ProFam and provide continuous on-job training to health workers to maintain a desirable standard of care. CLICK HERE FOR MORE ON THIS STORY 

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