ISSN 2326-7283
African Journal of Internal Medicine ISSN 2326-7283 Vol. 3 (10), pp. 294-300 November, 2015. © International Scholars Journals
Full Length Research Paper
A critical evaluation of health care reforms in Uganda and its implication on health equity
*William Biwott Ruto, Tegla B. Donald and Ezekiel K. Wanyama
Department of Chemical Pathology and Immunology, University of Nairobi, Nairobi, Kenya.
*Corresponding Authors. Email: [email protected]
Accepted 18 October, 2015
Abstract
Uganda Government has continued to strengthen the country’s health system by initiating policy reforms aimed at enhancing equity in health care. In this report, analytical review health care reforms are provided with their corresponding equity outcomes. This report is based on a review of both published and unpublished reports from the government of Uganda and multilateral stakeholders in the health sector from the review, various health equity issues were identified including high incidences of inefficiencies in health care such as stock-outs, low quality of health care under-table payments, increase of out-of pocket payments which continue to contribute towards high incidences of catastrophic health expenditures. Others include dilapidated health infrastructure, low morale among the health personnel, and low levels of spending by the government on health. The reforms have however, contributed towards efficiency gains in terms of increased use of lower-level government health centers and concomitant reductions in the use of hospital services. Various recommendations were suggested in lieu of the findings. These include increased investment in the health sector; strengthening supply of essential medicines, rehabilitation of health infrastructure, provision of incentives to health personnel. Other recommendations include supporting the operations of community health insurance and other pre-payment schemes meant to caution the poor from health expenditure catastrophe. Political commitment in increasing government spending on health care in line with the Abuja Declaration of 2001 is also recommended while putting in place policies aimed at efficiency in health care delivery.
Key words: Equity, health care reforms, financial protection, catastrophic health expenditure.