‘88 per cent of Ugandans pay for health’

Expectant mothers at Mulago hospital maternity ward. Many patients have to pay to access health services in Uganda. Photo by Rachel Mabala

What you need to know:

A survey has revealed that contrary to a presidential directive to abolish user fees, many health facilities are charging patients.

Kampala- Findings from a recent analysis of the health sector performance and the effectiveness of Uganda’s Minimum Health care package indicates that 88 per cent of households in Uganda pay out of pocket to access health services.

This, according to Dr Charlotte Zikusooka, a health economist at Health Consult – the organisation which conducted the survey, means that only 12 per cent of Ugandans actually get health services without parting with money.

The findings of the survey are in contradiction of the 2001 resolution by President Museveni to abolish user fees for health services.
The survey also shows that some 4.3 per cent people went below the poverty line as a result of expenditure on health.

Survey results were revealed during a two day East, Central and Southern Africa Health Community conference on Universal Health Coverage.

“Poor people spending on health care worsens the already bad situation by drawing them nearer to the poverty line while the rich and middle income earners could also become poor if the situation is not checked,” said Dr Zikusooka.

While opening the Conference yesterday, the Minister of State for Health, and General Duties, Dr Ellioda Tumwesigye, blamed the situation on poor financing for health, the high disease burden and the increasing population which put pressure on the available services.

“We are not doing well on health financing. The World Health Organisation recommends that $60 (Shs150, 000) be allocated per person but when you look at the next financial year allocation, it means that Uganda government will spend only $13 on every individual,” he said, adding that it is too little money and cannot provide even the basics. As a result, individuals have to pay out of out of their pocket for the services.

He also noted that while the budgetary allocation is small, the Health sector is among the four key sectors that take the largest share of the national budget.

“If we are to allocate 15 per cent as per the Abuja declaration, it would mean that we cut funding for the rest of the sectors which is economically not effective.”

Dr Edward Kataika, the Director of Programmes ECSA-HC, said there is need to protect the population against health care expenditure, calling on member states to organise their health systems to ensure that the out of pocket expenditure is minimised.

“Costs involved in accessing health care adversely affect people who pay out of pocket. as leaders and experts in this area, we have to find a way of giving people quality services but also protect them financially so that they don’t become poorer as a result of expenditure on health.”