Covid-19 presents opportunity to strengthen public health system

There has been a steady increase in private healthcare providers that is partly driven by a weak public health system.

With health insurance being the preserve of a privileged minority, there is high out-of-pocket expenditure on health that has driven many individuals and families into debt.

However, the Covid-19 response in Uganda has in many ways inadvertently pointed out to us what a functional health system should look like, and we must start thinking ahead on how to apply the lessons learnt from the pandemic.

First, the nature of response to Covid-19 necessitated strong State stewardship in order to contain the contagion. Even as the private sector brings in donations, the government is still taking control of making decisions on the priority areas.

This is a departure from the normal course of dealings where the donor sets the priorities, which has often times resulted in many unfunded priorities under the health sector ministerial policy statements.

Secondly, the Covid-19 pandemic has seen the health sector rightly shoot up in priority for budgetary allocations. All of a sudden, we all care about the number of healthcare workers in the country, as well as their protection.

Ordinary Ugandans cared to know the number of hospitals and ICU beds in the country.
The moment we focused on Covid-19, gaps were exposed in how to respond to patients with other ailments.

For example, we have seen mothers give birth by the roadside, which resulted in calls for emergency transportation services. We have also realised that health is an integral part of national security and, therefore, its financing is as important.

The focus on prevention that has required people to stay home and wash hands frequently to prevent catching the virus has underscored the importance of public participation in health policy development and implementation. Access to clean water in adequate quantities in order to prevent disease also came to the fore as an important underlying determinant of health.

Notably, the nature of the Covid-19 pandemic also made the case for the need for universal healthcare by showing us that no one is safe as long as their neighbour is not safe. That as a rich person, you could get the disease from your errand boy and that this errand boy has to be free of the infection in order for you to be free.

It was not surprising, therefore, that the government declared free treatment for all Covid-19 patients. The response to the pandemic also forced better inter-agency coordination that should characterise any proper health system.

Finally, to the delight of many ordinary Ugandans, the global lockdown has forced many policy makers who would otherwise have preferred to fly abroad for treatment even for minor ailments to turn to our local healthcare system. This has enabled some of them to witness the many inadequacies in the system, although what they have experienced is still a far cry from what the ordinary person goes through trying to access healthcare in the country.

It is hoped this experience will drive many policy makers to care more about improving the healthcare system at home. If Uganda is to learn anything from the Covid-19 experience, it should be the need for the nation to build a strong and equitable universal public health system with strong government stewardship.

Ms Namusobya is the executive director, Initiative for Social and Economic Rights (ISER)