By Stephen Twinoburyo
Recently the state of Uganda’s hospitals and health sector in general has become a hot topic of discussion and more especially after opposition leader, Dr Kiiza Besigye, visited Abim hospital in Teso.
There’s an argument, which I even heard Pres Museveni himself putting forward, that Besigye chose to visit Abim Hospital instead of ‘good’ health centres in the area. The fact however remains that Abim hospital exists, it has got patients and is under the condition we saw on TV.
I passed by Kiboga Hospital last month and it didn’t give a good sight. It doesn’t matter if there was a good health centre somewhere else in the region.
But let me look at Uganda’s health stats in perspective.
Infant mortality rate is 59.21 deaths/1,000 putting us at number 21 in the world, just behind Burundi (OMG!). This means that we are among the top 21 countries in the world where a child is likely to die before the age of 1. Our neighbours Kenya, Tanzania and even Sudan are far ahead of us.
The Maternal mortality rate is 343 deaths/100,000 putting us at number 37 in the world. This means that we are among the top 37 countries in the world where a woman is likely to die during pregnancy, at childbirth or immediately after childbirth. This rate is way above the Millennium Development Goals (MDG) target of 131 for 2015.
Life expectancy at birth is 54.93 years putting us at number 211 in the world. Only 13 countries are below us, the only non-African one being Afghanistan. Even the people of DRC live longer than us. According to World bank danta, we are below both the Sub-Saharan average and the low income countries’ trend.
World Health Organisation (WHO) defines a health system as “as comprising all the organizations, institutions and resources that are devoted to producing health actions. A health action is defined as any effort, whether in personal health care, public health services or through intersectoral initiatives, whose primary purpose is to improve health” and goes on further to describe health systems as having six building blocks: service delivery; health workforce; information; medical products, vaccines and technologies; financing; and leadership and governance (stewardship). The analytical summary of WHO states that “The overall health status of Ugandans remains poor, with a low level of life expectancy and a high level of mortality.”
The MDG Report for Uganda 2010 coming at a time of assessment of strides towards the Millennium Declaration in the last five years leading to the 2015 deadline acknowledged the achievements of the Ugandan government in the health sector. It however also noted that “for several MDGs, the progress has been too slow to meet the national and international targets—and, for some, there has been outright reversal. In some cases, improvements in national averages mask inequalities in progress, e.g., among the various regions of the country.”
The 2015/16 budget allocation to health (Sh. 1.27 trillion) is just over 5% way below the 15% agreed to at the Abuja Declaration 15 years earlier – and this share seems to have been continually dropping over the years.
We are lagging behind in the region and it’s important that we stop priding ourselves in mediocrity or comparing ourselves with low achievers. We should instead acknowledge that we have underachieved and aim higher. We are currently at a very low level social-economically, even in the region where we live except war ravaged South Sudan and eastern DRC.
The country’s 9.8% of GDP expenditure on health as of 2013 (including private health care) putting the country at number 53 in the world is very commendable – never mind that our annual GDP growth rate, even in 2017, is forecast by the World Bank to be lower than the Sub-Saharan average.