Building health centres good but not enough

President Museveni, the NRM presidential candidate, last week wrote an article in response to the debate that followed FDC candidate Kizza Besigye’s visit to Abim Hospital last month. Dr Besigye, while on a campaign tour of Karamoja sub-region, had made an impromptu visit to the health facility, which serves as a referral but had been deserted by patients because it had not had a doctor for the past year.

Following the exposure of the deplorable state of Abim Hospital, Dr Besigye said NRM has turned hospitals into mortuaries and there has subsequently been a lot of debate on the state of public health facilities. Abim Hospital, for instance, was built in the 1960s with a bed capacity of 200 but now has less than 20 beds with other facilities such as dispensaries abandoned to house bats and rats.

In response, Museveni castigated Besigye for dishonesty. The President listed his government’s achievements in the health sector, particularly pointing out that basing health centres at the sub-county and the county has caused a revolution in Uganda.
We agree that building health centres at sub-counties and counties is a great initiative that should solve the challenge of access to healthcare by the rural folk. But as the President rightly pointed out, some of the staff have problems of absenteeism and stealing of drugs, which inhibit provision of timely and quality healthcare to Ugandans.

To systematically address the chronic failure of our health services, we need to look beyond the health centres constructed across the country and address the issue of services offered by those health facilities. Last year, this newspaper published a special report that summed government health centres thus: “On a good day at a rural government health facility, when doctors are present…, drugs will be out of stock. On a bad one when drugs have been stocked, health attendants will be out of sight.”
The statement above reflects what happens in most public health facilities countrywide.

According to the Annual Health Sector Performance Report for the FY2013/14, seven out of the 14 regional referral hospitals have a staffing level below the average. The staffing challenges are compounded by poor remuneration, which has led to brain drain in the health sector. Data from the Uganda Medical and Dental Practitioners Council shows that of the 4,200 registered doctors as of July 31, 2013, only 2,021 had been licensed by the Council, and only 1,200 are involved in clinical medicine, a role for which they are trained.
As the presidential candidates make pledges about health sector reforms, they should acquaint themselves with the core issues affecting health service delivery and come up with concrete measures to tackle them.