As Uganda yet again experiences a surge in Covid-19 cases with the second wave fast spreading like bush fire across the country, spotlight is drawn to our health care system.
Referral hospitals are filling up with Covid-19 patients and this spells doom for the health system that was already struggling to contain the infection even at the onset of the pandemic.
Covid-19 patients are usually moved from upcountry health facilities to urban hospitals that are relatively better equipped to handle those cases.
Citizens, civil society organisations (CSOs), and other stakeholders have severally called for strengthening Uganda’s health system. Health infrastructure is composed of, among others, medical personnel, buildings, hospital equipment, communication systems, and equipment and ambulance and transportation facilities.
This includes establishment of new health facilities to provide a network of functional, efficient and sustainable health infrastructure at least within 5km walking distance to every homestead.
During the past three years, Ministry of Health recorded significant success in completion of various infrastructural developments including upgrade of 296 health centre II to health centres IIIs, construction of 10 theatres, 16 maternity wards and installation of 40,000 litre reservoir tanks for 26 health centre IVs across the country.
In 2018, government started construction, rehabilitation and equipping of referral hospitals, including the Specialised Women & Neonatal Hospital at Mulago, the Pediatric Surgery Hospital in Entebbe, Kawempe and Kiruddu hospitals. These have since contributed to decongestion of Mulago National Referral Hospital.
On that note, government should fast track renovation of Lower Mulago Hospital and health facilities at all levels in addition to construction of HCIIIs and HC IVs in newly created sub-counties and constituencies.
However, there is a continued mismatch between health infrastructure development and other resources such as personnel, staff housing, medical equipment, medicines and supplies across the country, this has resulted in inefficiency in investments and service delivery in the sector.
Accommodation for staff in existing facilities remains a very big challenge and is the major reason for low staff numbers as well as absenteeism as some health workers have to commute more than 20km from their place of residence to the health facilities on a daily basis.
Inadequate or poor medical equipment in existing facilities is also of great concern as many of the existing health facilities lack the necessary equipment.
The Auditor General in his 2020 Consolidated Audit report to Parliament, noted that only 909 out of the 3,569 (that is about 25 per cent) required number of medical equipment was available in 67 sampled health facilities (14 regional referral hospitals, 23 district hospitals and 39 health centre IVs).
Health facilities also facing inadequate facilitation for emergency services such as ambulances which has also crippled emergency responses across the country.
As we seek solutions, there is also an urgent need for development of a comprehensive policy on ambulance system in the country.
As a cost effective management measure aiming at minimising wastage of the already inadequate resources, Ministry of Health should boost the capacity of Regional Medical Equipment Workshops to routinely conduct supervision, maintenance and repair of essential medical equipment including ambulances.
Mr Jacob Opio is a tax payer from Agora, Kamuda in Soroti District.