Healthcare Reforms in Uganda

Healthcare Reforms in
Uganda
(1)
1. SWAp processes (which have encouraged
development partners to align their support behind a
coherent government-led strategy; see chapter 2,
Oliveira Cruz et al.);
2. Abolishing user fees in GoU units (which

immediately triggered a surge in demand and
catalysed a number of supply side reforms; see
chapter 3, Kirunga Tashobya et al.);
27-Feb-14 Philosophy of healthcare & System 2

3. Improved management systems (especially in
financing and supply of medicines; see chapter 4,
Nazerali et al.);
4. Public-private partnership (including US$9

million US$0.40 per capita in new grants to PNFPs;
see chapter 5, Lochoro et al.);
Specific reforms (2):
5. Decentralized service delivery (greater resources
and capacity building in district services; see chapter
6, Murindwa et al.);
6. Improved resource allocations (with a far larger

share of sector resources allocated to district primary
health care services, including PNFP providers; see
chapter 7, Ssengooba et al.);

7. Health financing (notably donors switching
from project to budget support and a reduction
in the reliance on patient fees)
8. Political leadership (from the President, the

Minister of Health and the Ministry of Finance).
Trends in health system change in
transitional countries like Uganda:
• From state provision to privatisation

(especially primary care)
• From allocated care to more patient choice
Philosophy of healthcare & System 6

• From centralised role of government to
shared power
• From paper based to Digital; medical

records management
The renewed definition of PHC
Focusing on the health system as a whole
• Include public, private, and non-profit sectors
• Recognize PHC as more than provision of health

services:
• Differentiate values, principles and elements
• Highlight equity and solidarity;
• Incorporate sustainability and a quality orientation.

• Specify measurable organizational & functional
elements
• Recognize dependency on other health system

& social processes
• Recognize need for each country to design their

own strategy
FAMILY MEDICINE / PREVENTIVE
MEDICINE / SOCIAL MEDICINE
“Let food be your medicine and medicine be your
food.” -- Hippocrates
• Preventive medicine is the branch of medicine
dealing with the prevention of disease and the
maintenance of good health practices.

Multiple health and social problems

The health care we want
• Guaranteed access
• Free choice of doctor
• High quality
• Affordability
• Trust and respect
Do we in Uganda have what it takes???

– Excellent hospitals, empty beds
– Enough well-trained professionals
– Robust research
– Current spending is sufficient
– Polls show the people are ready for change
– Large and small business are calling for change
Lifestyle is a choice
If you choose to live healthfully

beginning now, it can not only add years
to your life, but life to your years.

3. Occupational safety & health
• World Health Organization - is the promotion
and maintenance of the highest degree of
physical, mental and social well-being of
workers in all occupations by preventing
departures from health, controlling risks and
the adaptation of work to people, and people
to their jobs.

The discipline
• Occupational health and safety is a discipline with a broad
scope involving many specialized fields. In its broadest
sense, it should aim at:
– the promotion and maintenance of the highest degree of physical,
mental and social well-being of workers in all occupations;
– the prevention among workers of adverse effects on health
caused by their working conditions;
– the protection of workers in their employment from risks resulting
from factors adverse to health;
– the placing and maintenance of workers in an occupational
environment adapted to physical and mental needs;
– the adaptation of work to humans.
17 Philosophy of healthcare & System

In simple terms
• Occupation health is about the social,
mental and physical well-being of workers.

Importance of Occupational Health and
Safety
• Most Ugandans between the ages of 15 and 65 spend 40 to 50%
of waking hours at work.
• Thus it is very important that a person’s work place remain safe
and healthy. How worker’s all over the world face dangerous
hazards on the job everyday including:
– exposure to toxic chemicals
– excessive noise levels
– mechanical dangers
– heat or cold stress
– unsanitary conditions

Importance of occupational health to
workers
• Work-related accidents or diseases are very costly
and can have many serious direct and indirect effects
on the lives of workers and their families.
• For workers some of the direct costs of an injury or
illness are:
– the pain and suffering of the injury or illness;
– the loss of income;
– the possible loss of a job; leading to increased stress
and anxiety.
– health-care costs.
Occupational Health and Safety Act
• The national labour law requires employers to furnish
their employees with employment and a workplace free
from recognized hazards that cause, or could cause
death, harm, or serious injury.

4. SOCIAL DETERMINANTS OF HEALTH
– Differences between individuals within countries
– Differences between groups, populations and
countries
– Changes in health over time
• Complex pathways

Global Burden of Disease
From Ezzati et al, Lancet 2002
• Childhood and maternal • Addictive substances

undernutrition – Tobacco
– Underweight – Alcohol
– Iron deficiency – Illicit drugs
– Vitamin A deficiency • Environmental risks
– Zinc deficiency – Unsafe water, sanitation, and hygiene
• Other nutrition-related risk – Urban outdoor air pollution
factors and physical activity – Indoor smoke from solid fuels
– High blood pressure – Lead
– High cholesterol – Global climate change
– High BMI (overweight and obesity) • Occupational risks
– Low fruit and vegetable intake – Risk factors for injuries
– Physical inactivity – Carcinogens
• Sexual and reproductive health – Airborne particulates
– Unsafe sex – Ergonomic stressors
– Lack of contraception – Noise
• Other selected risks
– Unsafe health-care injections
– Childhood sexual abuse

Healthcare Reforms in Uganda

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Healthcare Reforms in Uganda

Uploaded by

Copyright:

Available Formats

Healthcare Reforms in

2. Abolishing user fees in GoU units (which

27-Feb-14 Philosophy of healthcare & System 2

4. Public-private partnership (including US$9

6. Improved resource allocations (with a far larger

27-Feb-14 Philosophy of healthcare & System 4

8. Political leadership (from the President, the

• From state provision to privatisation

• From allocated care to more patient choice

Philosophy of healthcare & System 6

• From paper based to Digital; medical

• Recognize PHC as more than provision of health

• Differentiate values, principles and elements

• Highlight equity and solidarity;

• Incorporate sustainability and a quality orientation.

• Recognize dependency on other health system

• Recognize need for each country to design their

Philosophy of healthcare & System 10

Philosophy of healthcare & System 11

Do we in Uganda have what it takes???

If you choose to live healthfully

Philosophy of healthcare & System 13

27-Feb-14 Philosophy of healthcare & System 15

17 Philosophy of healthcare & System

18 Philosophy of healthcare & System

19 Philosophy of healthcare & System

21 Philosophy of healthcare & System

27-Feb-14 Philosophy of healthcare & System 22

• Childhood and maternal • Addictive substances

Philosophy of healthcare & System 23

You might also like