CSOs Call on Government to Ensure Equitable and a Sustainable Health sector Financing in Uganda
According to the Sustainable Development Goal 3, target 8, member countries of the United Nations agreed to achieve Universal Health Coverage (UHC) including: financial risk protection; access to quality essential health care services and; access to safe, effective, quality, and affordable essential medicines and vaccines for all by 2030. However, prior to the COVID-19 pandemic, Uganda’s health systems are said to have been weakened by decades of under-investment in public health services. The COVID-19 pandemic exacerbated the underlying weaknesses of public health systems.
On 29th March 2022, SEATINI Uganda in partnership with Wemos, CEHURD, Action Aid International, Uganda National Health Consumer’s Organisation (UNHCO) and Uganda Debt Network (UDN) organized a stakeholder dialogue under the theme; Promoting Equitable and Sustainable Health Sector Financing in Uganda. The dialogue was aimed at identifying the impact of fiscal and monetary policies on social spending in the health sector as well as unpacking public financing management processes and policies on achieving health service delivery in Uganda. The dialogue brought together Members of Parliament from relevant Committees, policy makers, development partners, academia and other stakeholders at the national level.
In her welcome remarks, Ms Peninnah Mbabazi, Policy Analyst, Debt and Aid, SEATINI Uganda noted that COVID-19 greatly impacted Uganda’s health sector and therefore it is very key to ensure that the health sector financing priorities are clearly informed. She further noted that there need to know how the current fiscal and monetary policies can be improved to achieve inclusivity.
“It should be noted that Uganda got relief funds from the International Monetary Fund (IMF) to help us recover from the COVID- 19 pandemic. However, transparency in the utilisation of the funds has been a problem and a public outcry,” Ms Peninnah Mbabazi said.
Ms Jane Nalunga, Executive Director, SEATINI Uganda reiterated that middle income status can only benefit Ugandans who are healthy. Therefore, government needs to ensure equitable and sustainable health sector financing in Uganda.
‘‘Currently, healthcare is an important issue. We need to differentiate healthcare from medical care. Medical care is for the sick and healthcare is for those who are not sick,’’ Ms Jane Nalunga said.
Ms Odiirah Nansamba, the Public Relations Officer at Ministry of Health reiterated that the government’s overall objective is to have a health system that works for everyone. She revealed that Ministry of Health priorities are hinged on National Development plan III. She observed that although financing of the health sector is still very low, over 75% of the diseases most Ugandans battle with are preventable.
Ms Imdela Namagga, A Budget Advocacy Advisor, Uganda Health Systems Strengthening Activity (UHSS) brought to light that Uganda has so far made significant progress towards achieving Universal Health Care. By FY 2018/2019, health facility deliveries had increased by 15% from 55% to 63%. However, the figure declined to 59% in FY 2019/20 due to the effects of Covid- 19.
She further explained that allocations to the health sector increased from UGX 799 billion in 2011/12 to UGX 3,331 billion in 2021/22 representing a four-fold increase in funds allocated. Therefore, an increase in FY 2020/21 Health Budget was achieved due to additional allocations for interventions related to the COVID-19 pandemic response.
On the other hand, Mr Richard Ssempala, a Health Economist, School of Public Health, Makerere University noted Health status of Ugandans has improved over the last two decades. However, life expectancy at birth for Ugandans is still low. Approximately 1.9 million people are living with HIV(UAC-2021).
He called on the need for government to review its spending priorities and direct more money towards improving the health sector in Uganda.
“Government needs to extend tax relief and financial support to producers to encourage firm-specific actions that promote health for example producers of drugs,’’ Mr Ssempala said.
Dr Denis Kibira, a pharmacist, researcher and activist observed that out of pocket expenditure has also increased and yet government expenditure is reducing.
‘‘COVID 19 has shown us that we need to move towards self-sustainability and production of local medicine. We need to works towards harnessing the potential of traditional medicine due to its great role in our health system,’’ Mr Kibira said.
Participants recommended that;
- Government should explore the possibility of financing the health sector services using domestic sources. This is based on the fact that the donor funds are shrinking and this may result into huge burden on the country if we are not well prepared.
- There is need for more research and innovation in the area of traditional medicine and deliberate investment in the sector.
- There is need to put in place mechanisms to monitor and evaluate proper use of the finances allocated to the health centres in the different regions
During his closing remarks, Dr Charles Ayume, the Chairperson of the Parliamentary Committee on Health noted that the African Union (AU) member states signed the Abuja Declaration, thereby pledging to allocate at least 15% of their national budgets each year to improving their healthcare systems. However, the 15% financial commitment might not necessarily solve the problems of the health sector. He emphasized the need to address the broader challenges of the health sector/system beyond the financial pillar. There is need to adequately address Information Management Systems and Human Resource related challenges. He further called upon Members of Parliament to deliver on the National Health Insurance Scheme and also ensure that it also helps the people at the grassroot. He also proposed the need for government to prepare for the transition from development partners to self-sustainability in regards to financing the health sector.
