Government
should give special attention to the health workers
Uganda
is one of the ten countries globally which contribute the biggest proportion of
the annual global figures on maternal, newborn and child mortality. Every day
16 women die in Uganda
from pregnancy and child birth related causes. This translates 600 maternal
deaths every year! In addition, 121 children under the age of one month die
every day, which translates to 44,500 neonatal deaths annually. Furthermore the
annual death of children under the age of five stands at 94,400. All these
death are largely preventable with low cost high impact intervention.
Health
is a key element of social and economic growth and its one of the major
sectors that can directly impact on poverty eradication. Over the last four
years, this sector has on average received over 9.6% of the total national
budget, which is still far below the threshold of 15% agreed upon by African
leaders in the Abuja
declaration of 2001.
We are
concerned that Uganda’s health sector only covers 1/3 of what is needed to meet
the minimum health package yet health remains an important perquisite for
economic growth. Out of the $28 per
capita required to fully finance the minimum health care package only about US$
10.4 is provided. This is far below the per capita health expenditure of US$34
for low income countries. More than 90% 0f Ugandans live in rural areas and
these are the ones most affected by the weakened referral systems and equitable
distribution of doctors. They are being cared for by less than 10% of Uganda’s 3600 or so available doctors –manpower.
Despite the national rage of policies and heavy investment in agriculture in
rural areas, thousands of people continue to die needlessly. It’s therefore,
not surprising that out of desperation many patients resort to seeking health care from quack doctors such as faith
healers, witchdoctors while others simply remain at home.
The acute
shortage of medical personnel has
affected the performance of clinical
officers and nurses in that they have inevitably been called upon , from
time to time , to assume tasks that are beyond
their competence and which would have been carried out by doctors ,
often which disastrous consequences arise.
The current consolidated health workers
facilitation allowance of Ugsh
91,555 for senior
levels and 78,475 for junior staff and the monthly lunch allowance of UGX66,000 is too meager to cover the basic amenities for
which they were instituted .
In regional
referral hospitals where there are donor projects such as SUSTAIN that
contribute to staff salaries, the health workers have stayed. This is proof
that improved pay leads to retention.
Hospitals like mulago and butabika which are in Kampala find it easier to
retain health workers due to more opportunities for supplementing low salaries like participating in research ,consultancies and
private practices .Overall 40% of the health workers in Uganda are working in
private sector. In fact it’s estimated that 22% of these health workers are contracted
by PNFP and 21% by the private sector.
Government should come in and increase
on recruitment of health workers to allow deployment, retention of medical
personnel as well as increasing their
salaries. Increase the coverage of antenatal care from the current 42% to 70 %,
provide basic emergency obstetric and newborn care at all health centers
,reduce the unmet need for family
planning services from the current 40% to 20% by increasing the number of
service delivery points and access to commodities.
By Adellah Agaba