Health Sector Profile of Uganda
Health Sector Profile of Uganda
The sector is guided by the Health Sector Development Plan (HSDP) 2015/16 – 2019/20 aimed at achieving Uganda Vision 2040 of a healthy and productive population that contributes to socioeconomic growth and national development. The goal of the Plan is to accelerate movement towards Universal Health Coverage (UHC) with essential health and related services needed for promotion of a healthy and productive life. The health sector contributes to the third objective of the second National Development Plan (NDP II), ‘to enhance human capital development’. The sector focuses on increasing access to quality health services. The contribution of the sector is pursued through three key outcomes namely:
- Increased deliveries in health facilities;
- Children under one year old protected against life threatening diseases and
- Health facilities receive adequate stocks of essential medicines and health supplies (EMHS)
The strategic objectives of the HSDP are as follows;
- To contribute to production of a healthy human capital for wealth creation through provision of equitable, safe and sustainable health services;
- To address the key determinants of health through strengthening inter-sectoral collaboration and partnerships;
- To increase financial risk protection of households against impoverishment due to health expenditures and
- To enhance the health sector competitiveness in the region and globally.
A healthy and productive population will achieved through provision of accessible and quality health care to all people in Uganda through delivery of promotive, preventive, curative, palliative and rehabilitative care (Second National Development Plan [NDP II] 2015/16-2019/20).
Key Government interventions
The interventions in FY 2018/19 will include the following among others;
- The Uganda Heart Institute (UHI) now has advanced cardiac management facilities to handle at least 1,000 operations per year;
- Healthcare provision will emphasize prevention rather than cure.
- Strengthening human resource in healthcare provision to ensure the attraction, motivation, retention of healthcare professionals.
- Scale up preventive care by undertaking immunization initiatives including Hepatitis B, Malaria control, and HIV/ AIDS prevention and treatment;
Funding the health sector The allocations to health sector for FY 2018/19 is about Shs 2.3 Trillion when compared to allocation of
1,828.07 billion in FY 2017/18.
Key players in the health sector
The key players in the provision of health services include the following;
- Private sector;
- Not for profit organizations;
- Private health practitioners and
- Traditional and complementary medical practitioners.
Health sector performance
The following are the key sector outcome indicators in 2017/18;
Attaining a good standard of health for all Ugandans is major priority of this Government. The following interventions are being undertaken in FY 2017/18:-
- The HIV prevalence rate declined to 6% down from the prevalence of 7.3% in 2011.
- Twenty six million Long Lasting Insecticide treated mosquito nets were distributed nationwide achieving 94% coverage.
- To prevent Hepatitis B, 39 districts have been covered in West Nile, Mid North, Teso and Karamoja sub regions. 11 districts of Eastern Districts of Busoga region are currently being covered;
- Child survival has improved with the Infant Mortality Rate declining to 43 per 1,000 in 2016 from 54 per 1,000 live births in 2011. The Under Five Mortality Rate also reduced significantly declining from 90 per 1,000 live births to 64 per 1,000 live births over the same period;
MOH is a government body set up with the responsibility of policy formulation and policy dialogue with Health Development Partners, resource mobilization and budgeting, strategic planning, regulation, advising other ministries on health matters, setting standards and quality assurance, capacity development and technical support, provision of nationally coordinated services such as epidemic control, coordination of health research and monitoring and evaluation of the overall sector performance.
National Medical Stores
NMS is responsible for ensuring continuous distribution of pharmaceutical products in a financially viable and sustainable manner. The Ministry of Health directs distributions to the Districts
National Drug Authority
The National Drug Authority was established as a regulatory body responsible for regulation of drugs in the country. It was established by the National Drug Policy and Authority (NDP/A) Act, Cap. 206 to ensure the availability at all times of essential, efficacious and cost effective drugs to the entire population of Uganda as a means of providing satisfactory health care and safeguarding the appropriate use of drugs. The NDA is responsible for licensing and regulating the delivery of pharmaceuticals in Uganda and for testing all drugs including bioavailability and bioequivalence testing.
Uganda National Health Research Organisation
Responsible for coordination, alignment and harmonization of health research in the country. It is the body that sets priorities for essential national health research and adherence to research ethics and good practice. It comprises of two research institutes namely:
- Uganda Virus Research Institute
- National Chemotherapeutic Council
National Health Research Policy
This policy strengthens stewardship and governance of health research in the country and establishes a mechanism for alignment, harmonization and coordination of health research within the context of Uganda’s National Development Plan (NDP).
Uganda National Health Laboratory
This aims at providing a framework for ensuring that the health laboratory services in Uganda are strengthened so as to adequately support the effective and efficient delivery of the Uganda National Minimum Health Care Package (UNMHCP) to all people in Uganda, as advocated by the National Health Policy.
Government is undertaking key steps to improve health infrastructure in order to address constraints related to both healthcare access and quality. Key among them in FY 2017/18 include the following:
- The construction, expansion, rehabilitation and equipping of Mulago National Referral Hospital is in final stages and will be completed during next financial year. The 320 bed Specialized Maternal and Neonatal Health Care Unit at Mulago National Referral Hospital is also expected to be completed by December, 2018.
- The Cancer Institute has been expanded into a centre of excellence with the acquisition of advanced cancer treatment equipment including a linear accelerator.
The following interventions are planned in FY 2018/19;
- Upgrade 124 Health Centre IIs to Health Centre IIIs in 99 Local Governments, with support from the World Bank;
- Commence the construction of the International Specialized Hospital of Uganda at Lubowa, whose financing arrangements have now been completed.
- Continue the construction of the specialized Regional Centre for Pediatric Surgery in Entebbe which is expected to be completed in the next Financial Year; and
- 29 staff houses will be constructed, with the support of the Italian Government, at Health Centre IIIs in Karamoja region in the districts of Kaabong, Abim, Kotido, Moroto, Amudat, Napak and Nakapiripirit.
Challenges in the health sector
- Uganda’s per capita health expenditure at an average of US$56 is low compared with neighbours like Kenya (US$77) and Sudan (US$129)
- Remuneration packages for health staff have continously been inadequate.
- Inadequate staffing has in part resulted in non-utilisation of some key service delivery equipment.
- The health facilities are experiencing drug stock out in part due poor planning and budgeting resulting into a mismatch of supply and demand.
- Health facilities either lack, or received poor quality or incomplete packages of equipment.
- Inadequate funds for service delivery at lower level health centres (wage and non-wage) especially HC III, HC IV, and General Hospitals.
- Funding gap for ARVs, Anti malarials medicines and Laboratory Reagents leading to occasional stock outs
- Dilapidated health infrastructure in some hospitals and health centres have not been repaired for many years.
The information under the sector is organised as follows;