Rethink termination of health workers’ contracts
The president of UMA, Dr Samuel Odong Oledo (centre), accompanied by (left to right) nursing officer Maria Nantayi, the UMA chair of welfare, Dr Alone Nahabwe, and UMA’s deputy secretary general Faith Nabushawo addresses a press conference at Mulago Guest House in Kampala on March 30, 2022. PHOTO/ISAAC KASAMANI
What you need to know:
The issue:
Health workers’ contracts.
Our view:
The load that the contract workers have been managing will inevitably end up on the shoulders of an insufficient, and inadequately remunerated group of health workers.
On March 18, the Ministry of Health announced a decision to terminate the services of medical workers who had been recruited and deployed in Covid-19 treatment centres under the emergency response to Covid-19.
According to the communication that was sent to the executive director of the Mulago National Referral Hospital and directors of regional referral hospitals, the management of cases of Covid-19 has now been mainstreamed into healthcare service provision infrastructure that was in existence prior to the outbreak of the pandemic.
The ministry gives budgetary constraints and a fall in the number of Covid-19 infections as the reasons for this action.
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The directive, however, points to serious problems at the Ministry of Health. They suggest a lack of understanding of the state of the health sector on the part of those that are expected to foresee it.
The ministry did not provide figures to back up its claim that the number of infections has dipped, but even if it were true, which is debatable, Uganda has for quite some time now been dogged by an acute shortage of health workers. As of 2019, there was approximately one skilled health profession for every 1,000 persons. This makes a case for recruitment and not termination.
A research carried out in 2019 when the population stood at around 40 million revealed that staffing norms had not been revisited since 1999 when the population was about 21 million. That meant that whereas government had moved to fill some of the vacant positions in the health sector, the health worker-to-population ratio was way behind internationally recommended ratios.
It is inconceivable that officials in the Ministry of Health do not know that this had a negative impact on delivery of health services.
The ministry’s latest decision can only have one of two effects. It will either perpetuate the situation or exacerbate it.
Our own thinking is that it will exacerbate it. The load that the contract workers have been managing will inevitably end up on the shoulders of an insufficient, ill equipped, unevenly distributed and inadequately remunerated group of health workers.
These same health workers have for several years now been engaging in industrial action in order to draw government’s attention to their plight. Issues of welfare, lack of equipment and heavy workloads have been some of the causes of the industrial action.
The expectation would, therefore, have been that government would start addressing the problem of staff shortages by integrating those workers into the mainstream workforce. It is not too late to have a rethink.
