The Observer (Kampala)
Moses Talemwa
15 October 2008
Questions persist about government's commitment to providing quality healthcare, even as stakeholders continue to call for increased funding. Despite the Abuja protocol of 2006, in which African countries agreed to raise their budgetary contribution to health to 15% per annum, only Malawi has made it while Uganda is still lagging behind at 9%
A recent meeting of Partners in Population and Development (PPD) at Munyonyo heard how advocates were lobbying Parliament to help raise the contribution to the health sector.
The call comes on the back of concerns that the Ugandan population is growing too rapidly at 3.2% per annum. The majority of the population is rural based yet the state of rural health centres still leaves a lot to be desired.
The Minister of State for Health, Dr. Emmanuel Otaala, says that while the health sector needs more money, emphasis should be on the efficient use of available funds.
"Health-workers should realise that funds are hard to come by, so be efficient with what you have," he advised.
The statement is a blow to those hoping for increased government funding in the health sector. While the minister insists that the government is serious about healthcare, observers don't agree. "The minister has failed to persuade us that quality healthcare is a priority in this country," said Maj. Rubaramira Ruranga, an advocate for persons living with HIV/AIDS.
According to Ruranga, the government is committing more funds to security while at the same time declaring that there is no war in the country. He also claims that the bulk of monies sent to the ministry are spent on activities that have little to do with curing people, such as expensive 4WD vehicles for urban based officials. He adds that the majority of people living with HIV/AIDS are not even getting the anti-retroviral therapy that they need urgently.
But civil society has not given up the fight and is now lobbying regional parliaments to increase funding to the health sector. In their national budgets, Uganda and Kenya contribute 9% to the health sector, while Tanzania is at 11%.
According to Dr. Betty Kyaddondo of the Population Secretariat, MPs have been sensitised on how to increase maternal morbidity and mortality and a policy on the matter will be presented to the House, next month.
"We hope that they can persuade the state to increase its contribution to health," she says.
Most rural people still have to walk at least 10 miles to get to a health centre, but frequently get there to find little assistance, before resorting to herbs.
Otaala admitted that some rural health centres have no medicines while the National Medical Stores is spending a hefty sum on expired drugs. He puts it down to district officials who fail to collect the drugs from the National Medical Stores in Kampala. "We have sensitized them on their responsibility so we will not hesitate to take action against them, if they persist in their ways," he explained.
The minister says there are plans to increase the capacity of rural districts to dispense quality healthcare through provision of drugs.
The situation is not any better in the urban areas, where most qualified doctors have abandoned the major hospitals, or operate there part time, while concentrating on their private clinics where they earn more money.
The end result is that a large number of patients are not attended to at the hospitals. They resort to unchecked herbalists who frequently operate without the knowledge of the National Drug Authority or the National Chemotherapeutics Institute where the herbs are supposed to be checked for approval.
The meeting drew representatives from 15 African countries.
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