Improve service delivery at health centres

The Daily Monitor of January 30 carried a brief story titled, “Nurse arrested”. The story stated that a nursing assistant attached to Kibaale Health Centre II in Rakai District was arrested because more than 20 maternal deaths had occurred in the space of six months, at her private clinic. The district police commander, Mr Hashim Kasinga, said the suspect would be arraigned in court once investigations are complete.

Many questions arise as to how the nursing assistant ended up running her private clinic. Many sectors in the country have been privatised and indeed one is free to open up their private clinic, pharmacy or hospital. But there are rules that must be followed. In this case, questions arise as to whether the nurse was giving enough time to either of the facilities (the health centre II or her private clinic). Was she able to carry out her duties at both places? Was her private clinic competent enough to handle maternal cases, whether it is pregnancies or otherwise?
It is indeed possible that the nursing assistant started the clinic because she realised the need and believed she could provide services. Although health centres are meant to provide free health services to the people, many continue to face a myriad of problems in their running, probably forcing patients to find help elsewhere.

In the same Daily Monitor issue, was another story titled, “ Health centre disconnected”. The story told of how Kiyunga Health Centre IV in Luuka District has had its operations paralysed as it’s electricity supply had been disconnected over a Shs13 million bill. It is the biggest health centre in the district and has spent a month without power. Kiyunga is far from being the only one facing such problems. Last year, Daily Monitor published a story of how Nsinze Health Centre IV, which serves as Namutumba District hospital had not had a doctor for over a year, after the one it had left for further studies.

Other health centres suffer similar problems – a lack of enough staff, lack of enough equipment, and many other problems.
The 2014 National Census shows that although there has been an increase of people shifting to urban centres (currently 7,425,864 people), most of the population is based in the rural areas. As such, most of the health centre IIs and IIIs are found at the village and parish level where they are most needed.
If the Ministry of Health wants to ensure that Ugandans receive adequate health services, it should focus on ensuring that these health centres are running well.