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Universal health coverage key to Uganda attaining middle income status

FILE PHOTO: Previous recipients of free mosquito nets. Adopting Universal Health Coverage key to a healthy nation, needed in achieving Middle Income status

Adopt Universal Health Coverage to support the fight against COVID -19 and other related diseases in Uganda

COMMENT | JOHN OKIIRA | According to the first global monitoring report published by the World Health Organization (WHO), universal health coverage is viewed as an intervention that enables all people to receive the health services they need.

Universal Health Coverage (UHC) includes health initiatives designed to promote better health, prevent illness, and to provide the treatment, rehabilitation and palliative care of sufficient quality to be effective while at the same time ensuring that the use of these services does not expose the user to financial hardship.

The intervention has become famous with the global health policy and academic spheres as countries endeavor to attain the Universal Health Coverage target recognized under the Sustainable Development Goals (SDG) agenda.

To realize this objective, developing countries such as Mauritius, Egypt, South Africa, Tunisia, Rwanda and others have taken on bold policy initiatives that include the introduction of health insurance schemes and financing presence of critical human resources and health infrastructure for health services.

Over years in Uganda, the government introduced a number of initiatives in the health sector such as health infrastructure rehabilitation or renovation, upgrading and construction, distribution of long lasting treated mosquito nets across the country to prevent malaria and mass malaria treatment.

The Government also set up the National Medical Stores (NMS) as an autonomous body responsible for procurement, storage and distribution of essential medicines and health supplies to all public facilities and some Private Not for Profit ((PNFP) facilities through the push and pulls system in the country among others.

Despite the government’s initiatives in the health sector there are still some challenges that the health sector is facing today and these have been worsened by the COVID 19 pandemic that has  devastated nations, leaving many people dead and others highly vulnerable to hunger and poverty.

Whereas no death has been directly attributed to the pandemic in Uganda to date, many people especially those employed in the informal sector have lost their jobs and some succumbed to illnesses due to COVID 19 related restrictions and measures like the lock-down presented by Ministry of Health and the President of Uganda.

These made access to health services in most government health centres across the country difficult for the local population. Citizens in some localities of Uganda didn’t get required health services for illnesses such as Malaria, flu and cough because the medical workers didn’t have Personal Protective Equipment (PPEs) and hence feared to contract COVID – 19.

Dr. Margaret Chan, WHO Director-General in a statement emphasized that universal health coverage is the single most powerful concept that public health has to offer. It is inclusive. It unifies services and delivers them in a comprehensive and integrated way, based on primary health care.

Some of the countries in Africa such as Mauritius have since early 2000 taken a bold decision to adopt Universal Health Coverage for all citizens.

They have realized some gains through its implementation including; Increase in life expectancy (Life expectancy at birth averages 74.2 years), 100% of deliveries are attended by skilled attendants compared with the global average of 70%.

Prevalence of HIV/AIDS among the population is 0.86 percent and 100% of pregnant women have four antenatal care visits compared with the global average of 55%.

In terms of responding to the COVID 19 pandemic, the former President for Mauritius Ameenah Gurib in an interview with BBC noted that Universal Health Coverage in Mauritius has contributed to the zero active COVID 19 cases and less deaths related to the pandemic restrictions imposed by the current Government because health care is readily available and free all citizens in Mauritius.

Given the positives from UHC adoption, a healthy population is a prerequisite  for economic benefits needed to achieve and sustain Uganda’s vision for a middle-income country status by 2040.

Government needs to expedite the process of implementing affordable and accessible health options for all citizens in Uganda through the UHC adoption.

Several existing health sector concerns can be improved once Government concretizes steps to adopt a policy on UHC.

Equitable access to good quality health care services by all citizens will see the country address key issues of concern like infant mortality rate (43.351 death per 1000 live births), morbidity rate (6.403 per 1000 people) and HIV prevalence rate which currently stands at 5.7 percent among adults.

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 John Okiira is a Research Associate with the Advocates Coalition for Development and Environment (ACODE)

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