10 things government should do to improve healthcare
The Covid-19 pandemic has presented an opportunity for us to pass new policies to improve healthcare in Uganda. Here are 10 things government should do now to improve healthcare services.
First, government should retain the structure of decentralised health facilities, emphasize optimisation of available resources, add more facilities to match demand and ensure that they are well staffed and equipped.
In addition, the system of referrals should be clear and strictly adhered to particularly the health centre I and IIs. These facilities should exist in every village to lessen access delays and provide adequate primary healthcare
Village Health Teams should also visit homes regularly, and text or call people to promote community health while district hospitals, regional referrals and national referrals should handle more complex cases because practice makes perfect.
We need national health insurance. The scheme does not have to be perfect initially but the government can gradually cover the entire population over time as collections increase.
Establish emergency Care. An efficient emergency care and response system would lower accident and trauma mortality rates. Well-staffed and equipped trauma centres should be attached to the larger hospitals with greater capacity for handling complex cases to improve survival outcomes.
Telemedicine. Our health facilities should use telemedicine to unburden the facilities by treating certain patients remotely.
More so, government should compensate health professionals fairly. There are several payment schemes to explore and though no scheme is perfect, with careful monitoring and evaluation, a compromise can be reached that optimises patient outcomes, worker motivation and efficiency.
Training and Placement. Government should improve the training of all our health professionals and place them in facilities where they can refine their skills.
Employing the use of electronic medical records (EMR) system can build research capacity, improve efficiency and save lives. EMR and data science can identify disease hotspots, perform accurate surveillance, make predictions on disease outbreaks and use artificial intelligence for diagnoses.
Health innovation hubs. There are several innovations in healthcare happening in silos but scale is a challenge. Ministry of Health should operationalise hubs through which innovations in healthcare can be scaled nationwide.
There should be increased reliance on research and data science to influence decision making and constantly monitor efficiency metrics to identify which parts of the healthcare system are overloaded.
Government can widen the tax base, improve the collection process although over reliance on taxation is intellectually lazy and often regressive. Research and data can win grants to fund healthcare.
Negotiate revenue shares with the healthcare innovators in exchange for support in scaling inventions. Our higher tier health facilities can provide VIP services for the wealthy at premium prices and reinvest the surplus income in the health facilities
Government can also partner with development agencies to create specialised bonds to fund healthcare, like what the International Finance Facility for Immunization does with vaccine bonds for the Global Alliance for Vaccines and Immunisations.
There is no perfect static healthcare system. Technology changes, people change, diseases change and, therefore, healthcare must adapt as well.
Mr Opolot is a Global Health Specialist and Health Economist
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