What you need to know:
As Ugandans, we are very enthusiastic to see the operationalisation of this National Health Insurance scheme
A 2011 comprehensive review of Uganda’s Health System by USAID uncovered strengths and weaknesses of the health system, organised around the six technical building blocks defined by the World Health Organisation.
The assessment found that whereas significant efforts were being made to improve health in Uganda, more needed to be done.
On a lighter note, the average life expectancy at birth of Uganda has increased from 59.9 years in 2013 to 63.4 years in 2019. It is projected that by 2100, males in Uganda will have an expectancy of 74.5 and females 83.3.
Uganda has faced the worst pandemics in history such as Ebola, Marburg, Zika and now Covid-19. Ugandans now live in fear and uncertainty over the rising viral infections, coupled with poor health service offerings.
African governments are continually striving to stop the spread of communicable and other infectious diseases.
For instance, countries such as Zambia, Nigeria, Zimbabwe, Kenya, and South Africa have made significant strides to improve healthcare for their citizens by introducing strategic health planning, public health reforms, and adopting new technology.
Hence the motto of the public healthcare network is to make medical treatment of all kinds, affordable and accessible to everyone.
While outbreaks of new and exotic infectious diseases have surfaced all over the globe in the past decade, no continent has been hit harder than Africa.
Africa’s tropical climate makes it a hot zone in the most literal sense. The continent is a breeding ground for emerging pathogens and in the past few years, floods and droughts caused by global warming have exacerbated the situation.
As of 2016, the five leading causes of death in Uganda included communicable diseases such as HIV/Aids, Tuberculosis, malaria, respiratory tract infections and diarrheal diseases.
Rural access to health care remains a challenge in Uganda due to urban bias, social determinants of health, and transportation-related barriers. Health systems in Uganda lack equity, leaving disproportionately less health centre access for the poorest residents with the highest health care needs. The majority of health care resources are located within urban centres, with very few in rural areas.
Health systems in Uganda have been criticized for being too expensive and inequitable, with the poor receiving less-services than needed, and the rich receiving more than needed.
The Ugandan government has signed onto several international protocols aimed at increasing citizens’ access to good quality care and increasing financing to the health sector. Such protocols include the Common African Position on the post-2015 development agenda, the UN’s Sustainable Development Goals (SDGs) as well as the Abuja Declaration (2001) where it committed 15 percent of its budget to improving the health sector. However, this budget allocation is far from being realised.
The higher out-of-pocket expenditure (41 percent) has meant that sometimes, people have to sell their properties to pay for healthcare which has kept them in poverty. Yet, the Health Sector Development Plan (HSDP) 2016-2020 emphasized the need “to accelerate movement towards Universal Health Coverage”. And the renewed focus on UHC was in line with Uganda’s second National Health Policy (NHPII), whose overriding aim was to; improve access to the national minimum healthcare package.
On March 31, 2021, during a sitting chaired by the then Speaker of Parliament Rebecca Kadaga, the MPs passed the National Health Insurance Scheme Bill, 2019. When shall this Bill ever turn into law to see the light of the day? Clause 27(4) of the Bill provides for the establishment of the National Health Insurance Fund where funds of the Scheme would be kept. As Ugandans, we are very enthusiastic to see the operationalisation of this health insurance scheme that shall save us from the burden of exponential hospital bills.
Patrick Kagaba Kajuma, MPA student at Uganda Management Institute