Manifesto Week: Health Sector Outlines Achievements in Infrastructure and Staffing Levels


The new super specialized Maternal and Neonatal Hospital at Mulago.
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The Ministry of Health has reported a 5 percent increase in staffing levels in the health sector and an improvement in access to health care with 86 percent of the population within 5km of reach of either public or private health facilities, from 75 percent in 2010.

This was revealed by Health Minister, Dr Jane Ruth Aceng as she detailed the progress made in the health sector as the NRM government takes stock of its achievements in line with the 2016-2021 NRM manifesto.

According to Dr Aceng, the number of health facilities in Uganda has increased to 181 hospitals in 2019 from 156 in 2015 and 222 Health Centres IVs in 2019 from 193 in 2015.

The country has 1,510 Health Centre IIIs from 1,383 in 2015, 1,364 Health Centre IIs from 2,790 in 2015.

Infrastructure 

In regard to health infrastructure development, government has been rehabilitating and equipping Lower Mulago Hospital and the current progress of work is at 95%. The hospital has been partially opened for the management of COVID-19 patients. 

Construction of the Regional Specialized Paediatric Surgical Hospital was commissioned in February 2017 in Entebbe and has been completed. The hospital will serve Uganda and the East African region. 

ISHU is a specialized referral, tertiary treatment, research, and teaching hospital, which is intended to treat patients travelling out of the country to seek specialized medical care. 

On accommodation for health workers, more than 500 staff housing units have been put up at different hospitals and health centres. Some 26 twin staff houses were constructed with GAVI support in 15 districts and commissioned in 2018.

Another 68 staff housing units are under construction in Karamoja, 

Amuria, Kaberamaido, Koboko, Rukunyu, Kasana – Luwero and Mukono hospitals were upgraded from HC IVs in FY 2019/20 and are now operational. Construction of Buwenge and Bukwa General Hospitals commenced in 2009 and are yet to be completed

However, about 35 districts do not have any hospital (Public or private not for profit). Also, of the 296 constituencies, 69 do not have HC IVs. 

The Minister also said that 10 HC IVs were upgraded from HC IIIs in FY 2019/20 including Karita in Amudat, Nabiganda in Butaleja, Nyamirami in Kasese, Toroma in Katakwi, Rwebisengo in Ntoroko, Rukungiri in Rukungiri, Kajjansi in Wakiso, Warr in Zombo and Kawala in KCCA.

The Ministry plans to revamp the existing HC IVs so that all are able to provide emergency surgical services especially Caesarean Sections and blood transfusion. Under the Uganda Reproductive, Maternal and Child Health Improvement project, 41 HC IIs will be upgraded to HC IIIs and 40 HC IIIs renovated / expanded starting this December.

Staffing 

On human resource, the Ministry of Health says overall staffing level in public health facilities has risen from 70 percent in 2015 to 76 percent currently. 

“The target by 2018 was 80% however, creation of new districts and upgrading of health facilities increased the need for more health workers, thus falling short of the target. Whereas there are improvements in staffing level, there are still shortages in critical cadres such as Doctors at 51% gap; Anaesthetic Officers (30%); Dispensers (44%); Pharmacists (50%); and Theatre staff  (32%),” Dr Aceng said.

Vacant posts for Consultants and Senior Consultants in the national and RRHs in the country is at 61% while the gap for the specialized cadres is at 83%. 

Overall, the stock of qualified health profession available for employment in the health sector increased from 90,412 in 2017 to 101,350 by June 2018 but recruitment  is constrained by limitation of wage and failure to attract.

The current structure of the lower health facilities and RRHs is constricted and the Ministry of Public Service is leading the restructuring process. 

Salary enhancement for medical personnel was effected in FY 2018/19 and MoH is to undertake an assessment of the impact of the enhancement on motivation, retention and attraction of health workers. 

Dr Aceng says allocation for medicines and health supplies has been increasing from Shs 202bn in FY 2010/11 to Shs 396bn in FY 2019/20. 

Epidemics

Government has scaled up the surveillance of diseases such as Ebola and Marburg fever to ensure early detection and control. The Public Health Emergency Operation Center monitors all districts 24/7 for alerts and advises the concerned people immediately. 

“All the epidemics that occurred in 2018/2019 (Ebola, CCHF, Yellow Fever, Rift Valley Fever, Cholera and Meningitis) were confirmed quickly leading to controlling them in short periods. Currently, we are strengthening the systems to be more resilient. Permanent Isolation Centers are being constructed at Lacor, Entebbe, Mbarara and Mulago,” Dr Aceng said.

With the outbreak of COVID-19, MoH plans to strengthen the Port Health Services by recruiting full time staff, construction of Port Health facilities and strengthening surveillance and laboratory services.  

Cancer

A new Cobalt-60 Radiotherapy Machine was commissioned and construction of 6 more radiotherapy bunkers to improve the radiotherapy services is ongoing. A Linac machine was also procured and will soon be installed.

The UCI is in the process of establishing Regional Cancer Centres in Gulu and Mbarara to increase access to care. 

The EAC identified and approved UCI as Centre of Excellence for training, research and treatment of cancer in East Africa and expansion of the infrastructure is ongoing. Some 183 students have been funded to pursue different courses in cancer related disciplines including 14 specialist oncology fellowships and 10 PhDs. 

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