The level at which Uganda’s health system is dependent on donor aid is distressing. Like no other sector, health seems to have one of the highest components of donor funding in the country.
In the 20142015 financial year, for example, donor aid accounted for almost 26 per cent of the health budget, covering essential areas such as reproductive health, HIVAids and immunization.
While National Medical Stores (NMS) takes the third highest share of the health sector budget, inadequacy in the drug supplies continues to drag down quality of service delivery to the people.
The frequent stock-outs of essential medicines in health facilities is an indicator of the sorry state of our health system.
With persistently-low funding to essential areas like hygiene, sanitation and health research, there is no way we are going to have effective health promotion and a fully-functioning health system in Uganda.
Government needs to realize this before it is too late. The ministry of health should put more emphasis to the proper functionality of existing health facilities, by equipping them with essential medicines and avoiding the frequent stock-outs instead of building more facilities with poor services.
NMS can increase its level of transparency too. They should start publishing credit lines for districts and health facilities in the media and on public hospital noticeboards – so that we all know what is availed and what is not.
A survey conducted by Aocates Coalition for Development and Environment (ACODE) in 201011 showed that most health facilities, including local government officials, were not aware of their credit lines at NMS. Some health facilities reported that their requisitions were not consistent with NMS supplies.
On another footing, despite increase in the health sector budget over the last financial years, and the ministry of health putting in place maternal mortality reforms, which include improving family planning services, contraceptive prevalence rates are still very low.
Efforts by the ministry of health to purchase mama kits to be supplied by NMS are outdone by the over 1.5 million babies that are born every year. As a result, most of the mothers have to take their own items for delivery. Government, therefore, needs to increase spending on family planning commodities as stipulated in the reproductive health commodity security strategy.
It is also important that government procures family planning commodities used by men, especially condoms and surgical kits for vasectomy.
According to the National Health Investment Plan 2011-2015, about Shs 940 billion is required to cover the national need for pharmaceuticals, health supplies and commodities annually. Of this, essential medicines take only a meager 12 per cent.
There is limited appreciation of palliative care (providing care to the terminally-ill persons with severe pain, especially those with HIVAids and cancer) among some health facility managers. This coupled with inadequate funding to meet the training needs, required medicines, scale-up and monitoring and support supervision makes palliative services nonexistent in most health facilities.
A national household survey conducted by Uganda Bureau of Statistics shows that inadequacy of drugs at health facilities increased to 11 per cent in 200910. In addition, the ‘push system’ has increased the wastage of medicines that are sent but not required at various health facilities while creating shortages of non-basic but essential medicines that are required at the facilities.
As a matter of fact, the availability of essential medicines at health facilities should not be played around like a ball between NMS publicists and the public. Government needs to address this issue head-on.
The author is a communications officer at HEPS Uganda, a coalition for health promotion and social development.
Source : The Observer