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Related Experiment Videos

The challenge to restoring basic health care in Uganda

D O Okello1, R Lubanga, D Guwatudde

  • 1Clinical Epidemiology Unit, Makerere Medical School, Kampala, Uganda.

Social Science & Medicine (1982)
|February 17, 1998
PubMed
Summary

Uganda

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Area of Science:

  • Health economics
  • Public health policy
  • Health services research

Background:

  • A 1992-1993 survey in Uganda assessed health facility resources, costs, and financing.
  • Significant disparities were observed between government and non-government organization (NGO) facilities.

Purpose of the Study:

  • To evaluate resource allocation, operational costs, and financial structures within Ugandan health facilities.
  • To identify key challenges affecting service delivery and resource utilization.

Main Methods:

  • A comprehensive health facility survey was conducted across 10 districts in Uganda.
  • Data collection encompassed both government and NGO-managed health facilities.

Main Results:

  • Government facilities suffered from poor maintenance and disrepair.
  • User fee schemes were inadequate and not consumer-oriented.
  • Human resources and funding were concentrated in hospitals, leading to underutilization of lower-level facilities.
  • NGO staff received better compensation and incentives, resulting in higher motivation compared to government staff.
  • A shortage of qualified primary healthcare staff was evident, with unqualified personnel performing essential tasks.

Conclusions:

  • Improving efficiency in government health facilities requires optimizing resource use.
  • User fee systems can enhance facility resources but necessitate visible service quality improvements.
  • Decentralization empowering districts to manage personnel, including recruitment and compensation, is recommended.
  • A strategy involving reduced staffing levels and living wages for remaining personnel could improve motivation and service delivery.

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