Make counselling part of routine healthcare package

OPINION

I read a memo (dated April 9) from Uganda's health ministry inviting professionals willing to volunteer
their services in response to the national fight against COVID-19 pandemic. They wanted medical officers, assistant nursing officers, enrolled nurses, counsellors, psychiatric nurses and laboratory technicians.

This indicated that the ministry recognises the role of counselling in health care. Counselling refers to the help or emotional or psychological support offered to those with various challenges in health. It involves a discussion of thoughts and feelings in relation to tovarious mental health issues caused by numerous
health challenges.

Counsellors are experts in human behaviour and are have the capacity of helping people change from unhealthy to healthy behaviours. In case unhealthy behaviours are not given attention, they can water-down the good work, doctors and nurses do on the clinical side.

WHO defines health as ‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.' In other words, to be healthy, one must be physically, socially, psychologically and spiritually well. So, health cannot be complete if the psychological issues are not in a good state.

I believe it was against this background that the health ministry saw it fit to include counsellors on the health care team to address the health care needs of patients with COVID-19. However, having counsellors on the health care team should not cease after COVID-19 pandemic.

Even other people (patients) who go to various health facilities for various health care needs require counselling services. Uganda's national health care system from the lowest level to the national referral hospital does not have a position of a counsellor on the Government payroll. Does this mean that those going to the health facilities do not have counselling needs?

Do the few health workers who are burdened with high patient ratio really offer the desired quality counselling services, if any? I highly doubt it! Take, for instance, all HCIII's, HCIV's, all-district and regional hospitals offer HIV care to people living with HIV (PLWH). The health care team that offers health care services includes counsellors.

The counsellors are, however, not paid by the health ministry and their scope of work is only around HIV care issues. It is likely that after the CDC-funded health systems strengthening project, the counsellors will b withdrawn since they are not on the government payroll.

Counselling needs, if not attended to, can render even other good clinical services almost useless. It can impede the quality of health care and can significantly affect the desired health outcomes of disease management.

The writer heads the Health Sciences Department at Mildmay Institute