Special attention to health workers needed...

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