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HEALTH: Why women ministers were handed the baton

The Health sector also has to deal with massive brain-drain as Ugandan training doctors opt to escape to “greener pastures” as soon as the get their practicing certificate

Drake Rukundo, a health consultant, said public servants that occupy positions under appointment cannot be objective when they serve on management boards that they oversee.

Aceng has been a board member in many government health bodies, including the National Drug Authority (NDA), which has for many years been awash with stories of bribery, infighting, corruption scandals, and abuse of office. Will she now sort out the mess there?

Health story

Extraordinary performer

As Director General, Aceng’s job as a coordinator of all commissioners and directors meant that she often had to step in to fix things whenever they went wrong in the health sector which is described by many as “ailing”. She always appears to handle the pressure calmly and, where necessary, offered explanations to inquisitive journalists in an articulate fashion.

That is why people like Dennis Odwe, the Executive Director Action Group for Health Human Rights and HIV/AIDs (AGHA), a health rights organization, easily describe her as “extraordinary in performance”. He says Aceng is knowledgeable enough to steer conversations at cabinet level given her experience from the time she was the executive director of Lira regional hospital.

Odwe says he derives his confidence in Aceng’s abilities from how confidently she handled the crisis earlier in the year when Civil Society Organisations and the media put the Ministry on spot over mismanagement of donor funds. Even then, Aceng’s name was never among those touted in mainstream or social media as a possible candidate for the ministerial position, when the cabinet list was finally ousted in the evening of June 6, Aceng was allocated a post of Minister of Health replacing Dr. Elioda Tumwesigye who occupied the position for just a year.

Another pediatrician Dr. Joyce Moriku made it as the State Minister for Primary Health Care whereas Dr. Sarah Achieng Opendi was named the Minister of state for Health in charge of General Duties.

Apart from it now being an all women leadership, the three are trained medical professionals and by virtue of their technical knowledge, the president could have made the choice basing on their technical strength. But, is technical competence enough to rescue a country caught up in not just health problems but administrative challenges in major health institutions?

Robert Kyamureesire Rutaagi, a professor of Management says although experience in a particular field is important, good knowledge of principles of management is a must. Regrettably, he says, one of the reasons why ministers do not perform is their compromising on basic principles of management.

“They are appointed in ministries unrelated or irrelevant to their specialisations,” he says, “Permanent Secretaries are more permanent and powerful than ministers”.

Rutaagi, who is the chairperson of the Board of Directors of the Uganda National Meteorological Authority and former CEO of the Public Enterprise Reform and Divestiture Secretariat (PERDS) of the Ministry of Finance, has wide knowledge of the inner workings of the government.

He says the discipline of ministers is undermined and political interests they represent may subjugate ministry interests. He adds that a cabinet reshuffle, like the one just concluded, is inspired by political expediency and exigency – not principles of management. Efficient and effective management of a ministry he says “is a function of a fond interplay of internal and external characteristics, resources available, principles of management and managerial functions applied”.

Dr Aceng welcomes Sara Opendi at a recent Measles campaign. Both now in charge of Uganda's health. PHOTO WHO
Dr Aceng welcomes Sarah Opendi at a recent Mass Measles Campaign in Kyegegwa District . Both now in charge of Uganda’s health. PHOTO WHO

Rutaagi says all ministries have highly qualified individuals and the minister only comes in to supplement or provide political direction. “The minister should, therefore, allow other technocrats do their job with less interference but just provide leadership,” he says.

Bayiga says appointing a technocrat may be advantageous because her decisions might not be treated with political suspicion in a country where decisions are based on a political party’s interests.

He says, however, that even though she has vast technical expertise, Aceng is likely to face political challenges as most health issues have become political because health issues have become a point of criticism for the government.

He says during the just concluded presidential campaign, candidates resorted to visiting rundown health facilities in order to expose the government as failing. In the most publicized case, opposition Forum for Democratic Change (FDC) presidential candidate, Dr Kizza Besigye, visited Abim General Hospital in the Karamoja sub-region and exposed rot that sparked an international outcry.

Bayiga argues that Aceng may be a good manager, but she has risen to the top at a “difficult time when the government is losing popularity and the biggest chunk of the budget is allocated other sectors like security”.

But for Mulumba, Aceng’s elevation has created another worry for the Ministry of Health.

“The worry is about who becomes the next Director General?” he says. Getting a person who has not been in the Ministry would be a good choice “to balance the equation”, according to Mulumba. But, he is the first to concede that it “would pose a challenge”. That is another headache for Aceng.

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