A Critical Evaluation of the National Health System of Uganda
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 5, Issue 5
Abstract
This paper, presents a critical evaluation of Uganda’s health system with a justification using literal examples and illustrations based on key indicators of the selected relevant evaluative criteria. The aim of the paper is to present an assessment of the extent to which Uganda’s health system is effective in achieving its goals. Evaluating health systems is like measuring the social impact, which is difficult but necessary. Uganda’s Health System, like other systems, aims to achieve and sustain good health and well-being of its people. This is a formidable task that remains elusive but there are indications of progress in the positive direction. The Health System has been evolving over the last 3 to 4 decades to handle traditional (malaria), emerging and re-emerging (HIV-AID) as well as sporadic outbreaks (Zika, Ebola and Marburg) challenges that continue to escalate the disease burden and health situation in the country. Attainment of the broad purpose of a health system necessitates multi-stakeholder engagements in efforts to address the complexities in the system. Having many players working towards better health, good organization is paramount. The Uganda health Sector Strategic Plan is among other things, designed around a basic minimum health package, which targets cost effective interventions at the heaviest disease burdens. An important implementation problem of the Health Sector Strategic Plan (HSSP) is the chronic and substantial under funding of the health sector. The Republic of Uganda is a former British colony and landlocked country in East Africa, with a population of 32 million and land mass of 236, 040 square kilometers [1]. Uganda is a tropical country that lies within the East African Great Lakes Region and this geographical location and demographic factors are central to the shape and focus of the national health system [2]. For instance, the “Disease Traingle” which entails the causing agent (pathogen) interaction with host organism and the environment as illustrated see Figure 1 adopted from [3] has in the past favored sporadic outbreaks of Ebola, Marburg and Zika viruses which cause hemorrhagic fevers that were effectively curbed [4]. The tropical environment is ideal for malaria, which remains the leading cause of morbidity and mortality with the malaria vector varying depending on the climatic zones as indicated in Figure 2 [5]. These facts and indeed the growing disease burden arising from emerging and re-emerging major infectious and non-infectious diseases as well as other threats to health and well-being in Uganda are important considerations in the design and implementation of National Health System. Health system according to [6] entails all organizations, institutions and resources dedicated to securing health and well-being. This definition encompasses health actions and non-health actions within and outside the Health Sector that lead to desired health results [6]. Uganda’s health system has predominantly remained focused on healthcare aspects with emphasis on curative measures and not public health measures. This corroborates the paradox of health policy discussed [7]. The main factors in the evolution of Uganda’s health systems in the last four decades include external influences (including colonialisms and global agenda for health); governance, stewardship and leadership; conflicts and civil strive; funding; emerging challenges and burden of disease; and policies [8,9]. Uganda’s healthcare system works on a referral basis; if a level II facility cannot handle a case, it refers it to a unit the next level up. Often units don’t have the essential drugs, meaning the patients have to buy them from pharmacies or other drug sellers. This has resulted in an emerging lucrative private healthcare (Figure 3). Presents a summary of the Health System in Uganda, which is characterized by functions presented in Table 1. The goals of Uganda’s Health System is “Attainment of a good standard of health by all people in Uganda, in order to promote a healthy and productive life”; while the objective is “Reduced morbidity and mortality from the major causes of ill-health and premature death, and reduced disparities therein”
Authors and Affiliations
Nampala MP
Keywords
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- EP ID EP591806
- DOI 10.26717/BJSTR.2018.05.001266
- Views 299
- Downloads 0
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