Sunday April 20 2014

Won’t government improve service delivery without oil money?

By Margaret Wokuri Madanda

MP representatives on the Pan-African parliament are reported to have reached out to Ugandan medical experts in the Diaspora and implored them to come back and offer services in their country.

These Ugandans are said to have welcomed the idea but requested that government should acquire basic machinery that will enable them to do their work. When the parliamentarians delivered this message to President Museveni, he is reported to have told the MPs to pray that oil resources begin to flow so that such things can be sorted!

Without the oil money, there seems to be little hope of finding resources elsewhere to improve our health sector and that Ugandans will continue to live like drunk cockerels because of the lack of basic medicines and functional machines in health centres!

I will be proved wrong if the situation has improved but, the then shadow minister for finance, Oduman-Okello in his 2010/2011 budget response, vividly painted this sick picture of our health sector.

He noted that only 40 per cent of the available health equipment are in working condition; only 1/3rd of health- facility delivery services have basic equipment and supply for conducting normal delivery; less than a quarter of health facilities have all the essential equipment for basic (my emphasis) antenatal care and that drug stock outs were a chronic problem affecting 72 per cent of government health units.

It is worse when it comes to the human resource. The doctor -patient ratio is 1:24,725 below the 1:1,298 recommended by World Health Organisation (WHO). As a result, Ugandans have shunned public health centres; only 22 per cent of the population gets treatment from public health units. Then you have a dim picture of 320 Ugandans dying of malaria every day while 16 women die of pregnancy-related complications daily. Is this what Ugandans have to contend with until the oil money flows?

Yet, more worrying is that even if the oil money started flowing, there is nothing to show that things will be better. The operational environment shows that there is neither government will nor competence to channel resources to the common good. We are dealing with a government that is obsessed with soft and hard military ware all clothed in the name of security.

Writing about defence and security policies in, Understanding Public Policy, Thomas Dye categorises defence as a luxury good. Economists define a luxury good as one whose expenditure increases with income. Given that hypothesis, we can therefore expect that as soon as the oil money gets into our coffers, the biggest obsession by this government will remain acquisition of military hardware.

But assuming, for the sake, that there is will to improve the service sectors; does this government have the capacity to ensure that necessary resources are channelled to the desired sectors? Look at the mess that the Auditor General keeps unearthing each and every other year; if it is not ghost teachers; it is ghost pupils; ghost pensioners or PRDP money getting to personal accounts!

Government enthusiasts claim that with the proposed anti-corruption amendment Bill, things will get better. Yet, my perusal through this proposed Bill is that except for recovery of stolen money, there is nothing much it offers.

It would be very prudent if government focused on prevention rather that recovery. Prevention for that matter requires strong institutions to enforce agreed norms.
One school of thought opines that human beings are selfish and they will always do wrong and evil as long as they know they can get away with it. It is only good laws and their enforcement that can tame this human folly. In Uganda, we have the laws but the competence or the will to enforce is completely lacking. Even small things like proper disposal of kavera, use of seat belts or helmets for boda boda cyclists can’t be enforced. And we think oil money will deliver services- Ugandans are ‘Waiting for Godot’!