Uganda’s 1st Presidential Dialogue on Quality of Health Services

Last month, Global Health Corps fellow Meredith Hutchins and intern Marissa Ware represented Save the Mothers at the 1st National Presidential Dialogue on Quality of Health Services in Uganda. The conference was intended to serve as an interdisciplinary dialogue to discuss the challenges in providing equitable health care. It featured a series of panel discussions followed by a question and answer session. Marissa Ware captured a glimpse of the dialogue.

Robinah Kaitiritimba, who serves as the executive director for Uganda National Health Consumer’s Organization, believes “health begins at home”; a value echoed by Save the Mothers’ own efforts to address the delay in seeking healthcare to prevent maternal death from pregnancy complications. During the discussion, Robinah noted that health efforts need to be refocused towards the community: to build trust through accountability.

An audience member inquired about the reforms needed to improve the functionality of health unit management committees in order to increase accountability. These committees are formed with the intention of monitoring the general administration of mid-level health centers. Robinah spoke of the challenges they face:

“I have personally attended meetings of the health management and they do not know what they are supposed to do, they are not facilitated to do their job, and the health centre does not even know them. The other challenge for the committee has been that they are politically selected. The politicians find someone who mobilizes votes for them, somebody who needs a second opportunity in elections and rewards them by putting them on the committee. These are not people selected by [the] community, they are not representative, they are not necessarily interested in the issues of the community.”

Another audience member noted differences in the attitudes of health care workers towards patients in regard to public versus private care for those employed in both systems. The attendee asked, “The same health worker provides very good services within the private sector, but in public there are a lot of negative attitudes, discontent with the system. What could be the cause and what should be done?”

Robinah discussed the importance of governmental regulation in holding health workers accountable. She described the current situation of the health system in Uganda; many health workers are dual employed in the public and private sectors because they are not paid enough to maintain one place of employment. She said how the health system is being governed is the biggest problem. “Our health workers are completely demoralized. Salary is one part of motivation, but motivation is a lot of things. You need to have personal fulfillment in the job that you are doing. I think it is very demotivating for a health worker who has trained five years and they go to a health centre and they do not have the equipment that helps them grow and do their work and enjoy it. I have talked to medical doctors who work in health centres, and they tell you they have never been able to practice what they have learned. They don’t have equipment, they don’t have what they need, they are not supervised, so they just come and report and go.”

Save the Mothers’ Mother-Baby Friendly Hospital Initiative seeks to engage with Ugandan hospitals to help them become equipped to provide the care mothers need. While it is a small contribution to improving the overall health of mothers in Uganda, Save the Mothers’ staff are incredibly passionate to develop solutions and close the gaps surrounding maternal health care.

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