Govt ranks regions with best healthcare

A report released by the government yesterday indicates that the availability of services in healthcare facilities and the capacity of the facilities to offer the services are still “low”, signaling gaps in access and quality of care.

The figures in the report show that health facilities in Kampala, West Nile, South Central, Busoga, Tooro and Acholi had the best scores in the general service readiness index –the measure of the capacity of health facilities to provide services.

The facilities in the above areas scored between 0.60 and 0.66 in the general services readiness index, above the national average of 0.59. The above facilities were followed by those in Bunyoro, North Central, Ankole, Bukedi, and Kigezi, with Karamoja, Bugisu and Lango scoring the least in the general service readiness index. They scored between 0.54 and 0.58, indicating disparities in access to care.

This information is contained in the Harmonised Health Facility Assessment in Uganda, 2023, which was launched by the Health Minister, Dr Jane Ruth Aceng, in Entebbe during the 10th National Health Care Quality Improvement Conference.

The report is based on a cross-sectional survey conducted in 642 public and private facilities in 2022. The health facilities were selected through a stratified random sampling method designed to give representative estimates at the national level. The survey was done by Makerere University School of Public Health, and supported by the World Health Organisation (WHO) and the Ministry of Health.

“The study revealed that the availability of services in health care facilities in Uganda and the capacity of the facilities to offer the services was low but varied quite widely by type of health care service, facility level, public/private ownership, geographical region and urban/rural locations,” the report reads.

Prof Christopher Garimoi Orach, the Makerere University School of Public Health (MakSPH) team lead, said in an interview that there has been a general improvement in the availability of services and provision of care.

“We found that overall, general services availability and provision improved.  The general service [readiness] index improved to 59 percent, from 48 percent in 2018,” he said. 

“We also found that availability of interventions overall, has improved for various health domains. We found higher provision of reproductive, maternal, adolescent health services in various health facilities especially at higher hospital levels,” he added.

According to the report, more deliveries of mothers in health center IIIs and above are being attended to by skilled providers, a development which the MakSPH said has contributed to the reduction of maternal death in the country. 

“Nine out of 10 have been delivered through skilled attendants. Most health facilities are also offering immunisation services,” Prof Orach said.

However, the expert noted that that readiness to provide health services had some problems.

“For instance, in the areas of non-communicable diseases such as cancer diagnosis and management, we found that this is not being offered at a high level so, besides that, we also found that the readiness to offer transportation services to the person who requires them is low,” Prof Orach revealed.

Recommendations
“So we recommend that the ministry should improve and strengthen these areas. Diagnosis and treatment for cancer should be improved especially at regional referral hospitals so that many more people at the community level can access these services,” he added.

According to the report, the availability of essential medicines and equipment also varied widely across regions. According to the report, North Central had the highest percentage of facilities with WHO essential medicines (53 percent of 40 health facilities), followed by West Nile (53 percent), Kampala (52 percent), Bugisu (50 percent), and Karamoja (50 percent). 

Drug availability
All the other areas of South Central, Tooro, Acholi, Ankole, Lango, Kigezi, Teso, Busoga and Bukedi with the availability of essential medicines in the range of 41 percent to 48 percent.

Dr Jane Ruth Aceng, the Health Minister, said the government would continue to invest in the health sector and bridge gaps in access and quality of care.

“There are challenges that we continue to meet especially in the area of finance. It means we need to be more innovative to continue strengthening our health system. We don’t need very expensive innovations. We need to look for our own resources to end our challenges and we can only do this through innovations and quality,” she said.

“We need to reduce wastage, and increase our effort and attention in the work we do. Do we keep time or do what we should do adequately? We are losing maternal lives because we are not thinking, we are not giving enough time,” she added. 

Reactions
Prof Christopher Garimoi Orach, the Makerere University School of Public Health  team lead: “We found that overall, general services availability and provision improved.  

The general service index improved to 59 percent, from 48 percent in 2018. We also found that availability of interventions overall, has improved. We found higher provision of reproductive, maternal, adolescent health services in various health facilities.”

Dr Jane Ruth Aceng, the Health Minister: There are challenges that we continue to meet especially in the area of finance. It means we need to be more innovative to continue strengthening our health system. We don’t need very expensive innovations. 

We need to look for our own resources to end our challenges and we can only do this through innovations and quality.

We need to reduce wastage, and increase our effort and attention in the work we do. Do we keep time or do what we should do adequately? We are losing maternal lives because we are not thinking, we are not giving enough time.”

General Service Readiness index
National 0.59 (636 health facilities assessed)
 
Government facilities 0.55 (361 health facilities assessed)

Private-Not-For-Profit facilities 0.68 (137 health facilities assessed)

Private Health Practitioners 0.63 (138 health facilities assessed)
 
Kampala 0.66 (99 health facilities assessed)

West Nile 0.66 (40 health facilities assessed)

South Central 0.60 (84 health facilities assessed)

Busoga 0.60 (47 health facilities assessed)

Tooro 0.60 (42 health facilities assessed)

Acholi 0.60 (28 health facilities assessed)

Bunyoro 0.58 (27 health facilities assessed)

North Central 0.57 (64 health facilities assessed)

Ankole 0.57 (50 health facilities assessed)

Bukedi 0.57 (27 health facilities assessed)

Kigezi 0.56 (33 health facilities assessed)

Teso 0.56 (29 health facilities assessed)

Karamoja 0.56 (16 health facilities assessed)

Bugisu 0.55 (27 health facilities assessed)

Lango 0.54 (23 health facilities assessed)

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