By Joachim Buwembo
Ugandan Christian intellectuals have drawn President Yoweri Museveni’s attention to the extreme underfunding of the country’s health system and the irrational expenditure that wastes trillions of public funds on treatment of individuals abroad.
In a report they have sent to the president, the intellectuals under their umbrella Fellowship of Christian Unions (FOCUS) Uganda highlight the fact the (rather crude) out of pocket payment for treatment that most Ugandans practice is actually more than double what government spends on healthcare.
The people pay 37%, government 15.3% and donors 41.7 percent of the overall health bill.
The report, which FOCUS will make public on Wednesday has some bizarre revelations like the fact that the government spent about half a trillion shillings in 2016 sending some individuals for medical treatment to India alone while a mere fifth of that amount is all it took to build the new 450 bed Mulago Women and Neonatal Hospital, built from foundation to finish, and fully fitted with state-of-the-art equipment, including a newborn ICU.
Another bizarre affair noted in the report is that most district hospitals in Uganda each get only about Shs 20 million a month for all its non-wage expenditure, an amount way below what is given to a single member of parliament. Every district has several MPs.
The report titled ‘Major Health Challenges Facing Uganda And How We Can Overcome Them’, blames the public health facilities for failing patients by not providing basic but life-saving services like imaging technologies, diagnostics such as blood sugar monitoring, access to key medicines such as Insulin for diabetic patients and medicines for high blood pressure, and “lifesaving operations and procedures, such as caesarean sections and assisted deliveries are often unavailable without upfront payments”.
The Christians also remind the president that the breakdown of institutionalized Primary Health Care has reduced health system to merely being hospital based, yet the hospital facilities are no longer even subjected to routine inspection.
They also notify the president of the absence of an ambulance system. (There are some ambulance vehicles belonging to some hospitals and others belonging to politicians but no national all local government ambulance systems.)
The Christians also decry the organizational void that keeps the country without a medical referral system.
In their recommendations, the Christians propose that:
a) government abolishes funding health care of Ugandans abroad; and instead, invests that money in the Uganda’s public health system.
b) that government abolishes funding in-country health care of public servants and politicians in private health care institutions. All such government-funded health care should be restricted to government institutions; to ensure improvement of the system and that.
c) Uganda develops a robust national health service funded from the taxpayers money as opposed to contributory schemes to ensure equity in access and avoid disadvantaging the poor, the unemployed, children and the older persons who tend to be excluded or disadvantaged by contributory schemes.