The healthcare history in Uganda reveals that by 1986, the health sector was in a state of near collapse with dilapidated and very poorly equipped public health facilities.
During this period, health workers in the public sector were demoralised due to very low and irregular wages. Public funding for the sector was unreliable and at its lowest at 2.5 per cent of the national budget in 1987/88.
From 1986, when the NRM government came to power, Uganda embarked on major reforms.
In the health sector, the immediate emphasis was on rehabilitation of the existing facilities to restore functional capacity, and a shift of emphasis to primary healthcare with a defined minimum package of cost-effective services.
As in other developing countries, bilateral and multilateral development partners increase funding to the health sector and encouraged alternative mechanisms of financing health services.
The reforms in health system shows that health facilities ownership by government has grown to a total of 1,708 health facilities according to the Ministry of Health inventory (2005–2010).
This is because health facilities act as an interface between the health service delivery and the community.
They house equipment and technologies, and act as a springboard from which outreach services are provided to facilitate accessibility to both curative and preventive health services.
Effective healthcare delivery requires a network of functional health facilities, and presently, the coverage in Uganda is estimated at 72 per cent. Over the years, government committed a lot of resources to construct Health Centre level IV at every constituency to reduce problems of maternal deaths in the country.
The public healthcare system in Uganda has undergone transformation as a result of proactive government policies.
There has been expansion of health infrastructure to achieve greater coverage, rehabilitation and upgrading of some existing infrastructure, continued human resource development for effective and efficient management of the health system.
As the government continues with reforms in the health sector, it introduced the National Health System, which encompasses the National Health Policy and Health Sector Strategic Plan.
This move saw the development of a new 10-year National Health Policy (NHP) and a five-year Health Sector Strategic Plan (HSSP).
The NHP was launched in 1999/2000 and the HSSP at the beginning of the Financial Year 2000/01.
The NHP and HSSP seek to enhance the health status of the population through a minimum package of services comprising the most cost-effective interventions that address the major causes of burden of disease was articulated.
The package known as the Uganda Minimum Health Care Package was intended to be the cardinal reference in determining the allocation of public funds and other essential inputs. According to the Health ministry’s Health Sector Strategic Plan 2005/06 - 2010/11, the country had 2,545 health facilities then covering all the districts.
The development of a 10-year National Health Policy and a five-year Health Sector Strategic Plan brought fundamental changes in the health sector planning and development, as stated in the Health ministry’s National Health Accounts 2004.
Uganda’s health system is a combination of public and private financing and provision of health services.
The major providers include the public, private not for profit, private health practitioners (hospitals), traditional and complementary medical practitioners and the informal sector.
Private health practitioners presently encompasses all cadres of health professionals in the clinical, dental, diagnostics, medical, midwifery, nursing, pharmacy and public health categories who provide private health services. The private health practitioners provide mainly primary level services and limited secondary level services.
Ms Birungi Mugisha is the head of broadcast and print communications, office of the national chairman - NRM.