Address malaise in health sector in structured way

President Museveni, on August 3, for the first time during his 30-year rule, addressed an impromptu gathering at a government-run health facility and instantly “fired” all its medics and other health workers in response to complaints of poor service delivery and lack of drugs by residents of the area.
This was at Nakawuka Health Centre III, Mpumudde Village, Wakiso District. The loud cheers that greeted the President’s unprecedented action would, just within hours of the Head of State’s departure, be replaced by despair as the health facility was shut down.

We must restate at the onset that the state of health service delivery in the country is depressing in most respects, a subject that has been comprehensively covered in the media over the years.
President Museveni, therefore, is understandably concerned by the state of health facilities in the country. And he has taken measures in the past, including setting up a drugs monitoring unit in his office to curb the pilferage of drugs from public health centres.

Shortly after the February elections, President Museveni paid an impromptu visit to Mulago hospital, arriving unannounced and catching the workers unawares. He made his observations, talked with the heads of the hospital, and on that occasion left without making any declarations.

It may be that the President is frustrated that his earlier directives were not followed. And by doing what he did at Nakawuka Health Centre III, he was perhaps looking for a new approach to handling what many agree is one of the most serious problems of our country.

But it is important to consider the implications. If the President’s directive is followed through and the workers at Nakawuka Health Centre III are fired, for instance, one would expect them to sue the government over the decision.

But, probably more importantly, the President won’t be in position to monitor all the government health centres to enforce compliance. According to Ministry of Health data for the year 2010, the government owned 2,655 of the hospitals and health centres I, II and III in the country, which accounted for 62 per cent of all health facilities in Uganda then. They are now more, yet there are many other sectors that are begging for the President’s attention.
The health sector can therefore only be conclusively dealt with through implementing well thought out reforms as opposed to the President taking random actions in response to public uproar.