The old proverb that health is wealth has never been truer. This is because good health is a strong foundation on which success and prosperity of a nation can be built. Yet, despite significant investment by bilateral and multilateral partners over the past decades, Uganda’s healthcare performance is still ranked as one of the worst in the world by the World Health Organization. In 2013, the country was ranked 186th out of 191 nations. Uganda also has one of the highest maternal mortality rates in the world (375 per 100, 000 live births). The country has lagged behind in meeting the UN development goals to reduce maternal and infant deaths by 2030. Several significant challenges plague Uganda’s health care system. Kiguli (2009) lists some of them; shortage of trained healthcare workers, brain drain, medicine stockouts, limited resources, inadequate equipment, long wait times, inadequate preventative care, poor referral systems, high costs, lack of trust in health workers by the general public, lack of services for vulnerable populations like the poor and elderly, few and distant health facilities (especially in rural areas), no authenticity/foreign dependent systems that disregard research into the development of indigenous health solutions., among many others.
Kiguli (2009) adds that these challenges affect the quality of services dispensed. The quality of services in turn affects utilization in different ways, including preventing patients from seeking out delivery services or leading them to see traditional providers, initiating self-medication, and deciding not to seek formal care or seeing private providers. Even more stark is the realization that only 38% of healthcare posts are filled in Uganda. 70% of Ugandan doctors and 40% of nurses and midwives are based in urban areas, serving only 12% of the Ugandan population. This implies that access to health care between rural and urban areas is highly imbalanced. With most Ugandans living in rural areas, their ability to pay for better healthcare in urban centres is limited. This uneven service discourages patients from seeking out professional care, especially in rural areas with longer travel times.
Since 2020, the COVID-19 pandemic has further battered an already challenged Uganda health care system. With a second wave of cases surging, the government has instituted a lockdown characterized by social distancing and stay-at-home interventions, advocated by the World Health Organization (WHO). As the number of reported infections increase countrywide, more stringent measures have taken root. These include closure of workplaces and severe restrictions on travel, aimed at reducing transmission. Nonetheless, Uganda remains particularly vulnerable to COVID-19 because of the weak health service infrastructure, low health worker – population ratios and preexistent public health issues such as HIV/AIDS, Malaria, Tuberculosis, among others.
More than ever, health services are stretched thin. Health workers and direct care givers of COVID-19 patients are at risk of infection and death. Closure of logistics-related workplaces and transport services interrupts the supply of essential medicine. Travel bans and reduction in public transportation limit access, and public perceptions of increased risk of COVID-19 infection near health facilities discourage attendance, while health facility activities considered “non-urgent,” such as antenatal care and immunization, have been postponed.
These numerous sector challenges create need for urgent solutions so that Ugandans can have better health to create more wealth and afford basic needs.
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