Ugandan Doctors: We’re At Breaking Point


information pills geneva;”>The state in which many Health Centres in Uganda are in particularly referral hospitals should motivate the Government to invest in health services.

In Uganda, Health Service delivery is financed by the Government, private sources and development assistance under the sector wide arrangement.

“Of the country’s expenditure of health for financial year 2010/2011, capital expenditure accounted for 17% of health sector public expenditure,” Ministry of Health 2010/2011 report indicates.

In some areas in Uganda especially upcountry, one can hardly get a hospital nearby and people are dying every day because of lack of medical attention, lack of enough health and medical services.

Therefore the Government should increase on the funding in the health sector so that more medical workers ( doctors, nurses, midwives, pharmacists) are recruited, improve on the state of Health Centres, get more medical facilities and increase on the payment of health workers so as to make them motivated to work.

Many referral hospitals do not have enough equipment to carry out their medical services and that is why people prefer private hospitals to government ones.

With a population of 34 million in Mulago Referral Hospital, there are a few and countable wheel chairs supposed to be for patients who face constraints as they enter the hospital gate. This should be the role of government to invest more in such medical facilities.

Other hospitals are congested and because of that, they have started harboring thieves, fake doctors who masquerade as health workers and take advantage of the big crowds in the hospitals and even extort money from the patients.

If the Government increased on the funds given to the health sector, such hospitals would be expanded.

Mulago Referral Hospital’s official bed capacity is 1,643 beds but its population has grown tenfold.

According to Dr. Baterana Byarugaba Executive Director of Mulago, about 2000 people come to the Hospital daily, 700 patients for review, 300 for emergency cases and 1000 as visitors while others are attendants to the patients.

He said that these crowds pose a security challenge and Mulago remains one of the most terror prone areas.

Mulago administration now struggles to decongest the hospital by allowing one attendant for a patient but this will not help on reducing the population. The government should instead invest more funds to help the hospital buy more beds for patients, reduce on the crowd and construct more infrastructure to cater for all the patients.

According to the Ministry of Health (MoH) Annual Health Sector Performance Report Financial Year 2010/2011, it shows that there was 39% of deliveries in health services and the performance trend from the Health Sector Strategic Investment Plan (HSSIP) indicated that it was improving but below the target level. This should be one of the reasons why Government should invest more funds in the health services.


Some government hospitals do not have enough trained personnel to cater for all the patients and as a result patients die because of no medical attention.

A doctor who spoke to Chimpreports on condition of anonymity said: “We are breaking point.”

The report also shows that the level of staffing with trained health workers was static at 56% and this is attributed to no recruitment taking place in the local Governments during the year under review as directed by the Ministry of Local Government.

The Ministry’s mission is to provide the highest possible level of Health Services to all people in Uganda through delivery of promotive, preventive, curative, palliative and rehabilitative health services at all levels.

So how can MoH achieve all this if the Government reduces on the funding given to the Health Sector?

Many diseases are killing people in Uganda because of inadequate supply of medication in hospitals and lack of trained personnel.

“A total of 13,761 hospital deaths were reported, Malaria on top with a 20.9% and a total of 2880 deaths, followed by AIDS with 9.4% and total of 1,291 deaths,” indicated in the MoH 2010/2011 annual report

The performance against selected HIV/AIDS Programme lead indicators shows that the progress on the proportion of health services with HIV/AIDS Counseling and Testing (HCT) services was slow due to inadequate supply of kits and availability of trained personnel.

The report also gives statistics for the staffing levels in Public Sector filled by trained health personnel, Doctors with 47%, Nurses with 58% midwives with 67% and Health Assistants filled none in Mulago, Regional Referral Hospitals and District Health Officers

The density of health personnel in Uganda is still very low according to the health worker population ratio. “Overall, there are 1.49 core health workers per 1,000 population and still below the World Health Organization recommended minimum of 2.3 per 1, 000,” indicated in the 2010/2011 annual report.

According to the report, the main challenges faced in the Ministry of Health are poor attraction and retention of staff across the country, limited funding for recruitment, salaries and wages which has resulted into high vacancy levels and remuneration of health services.


Also its recommendation for annual plan 2012/2013 is to improve funding to the sector and working conditions (equipment and accommodation).

In the report, Uganda’s progress is compared to 11 peer countries which helps to put national progress into perspective. These countries are Burundi, DR Congo, Ethiopia, Ghana, Kenya, Malawi, Mozambique, Rwanda, Tanzania, Zambia and Zimbabwe.

They are similar in terms of socio-economic development, epidemiological situation and geographic location.

According to the 2009 and 2010 data from WHO, World Health Statistics report, Uganda was the third out of 12 in the health input indicators, for coverage indicators was the 10th out of 12 and 7th out of 12 for the health outcome indicators.

So overall it showed that Uganda was slower than the other peer countries during 1990-2009.

“Some of the challenges faced at Mulago Hospital are understaffing, under funding, high patient turn up and poor infrastructure especially for staff accommodation,” indicated in the MoH report.


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