Rukungiri District is grappling with a severe shortage of health workers, operating with less than one-third of the required staff, a situation authorities say continues to strain healthcare delivery despite improvements in some health indicators.
According to the District Health Officer, Dr Kasima Muchunguzi, the district currently runs 95 health facilities of different levels, but staffing remains critically low under the revised national health staffing structure.
“Human resources for health according to the new staffing structure show that our district is at 28.8 percent of the approved posts,” Dr Muchunguzi said.
“Our overall gap is 71.2 percent, which translates to about 940 positions, yet we currently have only 381 health workers in service.”
He noted that the shortage significantly affects service delivery, particularly in high-volume facilities such as Health Centre IVs.
“The staffing gap greatly affects service delivery. For example, our Health Centre IVs averagely conduct between 150 and 180 deliveries per month, which puts enormous pressure on the few health workers available,” he explained.
Dr. Muchunguzi attributed the persistent staffing shortages to limited wage allocations and a prolonged freeze on recruitment across several financial years.
“This staffing shortage has persisted due to inadequate wage allocated to the district and the continued freeze on recruitment over the last many financial years. Several requests for additional wage allocations have been made to the respective ministries,” he said.
He added that the district has recently submitted appeals to key government institutions including the Ministry of Health, the Ministry of Local Government, and the Ministry of Finance, Planning and Economic Development seeking intervention.
Despite the staffing challenges, Rukungiri District has made strides in improving service delivery through an integrated model of health services.
District health authorities say all facilities have been supported to implement routine client satisfaction feedback mechanisms, which have contributed to improved public perception of healthcare services.
“Through this approach, we have recorded an overall client satisfaction rate of 78 percent across our health facilities,” Dr Muchunguzi revealed.
The district has also reported a decline in maternal deaths, a development health officials attribute to improved monitoring and service coordination.
However, perinatal deaths remain a concern due to systemic challenges within the health system.
“The district still registers a number of perinatal deaths mainly due to the lack of neonatal intensive care units, capacity gaps among health workers, lack of essential equipment, and inadequate infrastructure,” the DHO noted.
In an effort to strengthen community-level healthcare, the Ministry of Health has commissioned 210 Community Health Extension Workers (CHEWs) who recently completed six months of training.
Health officials believe the CHEWs will play a critical role in health education, disease prevention and early detection of illnesses within communities.
Speaking at the graduation ceremony of the CHEWs, the Permanent Secretary at the Ministry of Health, Dr. Diana Atwine, announced that the government plans to upgrade Health Centre IV facilities under the new health system structure.
“All Health Centre IVs in our new structure are community hospitals and they will all be uplifted to work as big hospitals,” Dr Atwine said.
She said the move is expected to strengthen referral systems and expand access to specialized care closer to communities.
Meanwhile, the Minister of Health, Dr Jane Ruth Aceng, urged the newly commissioned CHEWs to prioritize community engagement rather than remaining in health facilities.
“You are not supposed to spend all your time in the health facilities but in the communities interacting with the people and educating them,” Dr Aceng said.
She stressed that the CHEWs programme is designed to bridge the gap between communities and health facilities, particularly in areas where health worker shortages remain acute.