In this first part of our two-part series, PML Daily’s Javira Ssebwami looks at the achievements in Uganda’s Health Sector since 1986, taking us through the methodical background that had prepared its current wins.
KAMPALA –The National Resistance Army (NRA) captured power after five years of protracted fighting on January 26, 1986, dealt a final blow to the Uganda People’s Congres and Dr. Apollo Milton Obote’s second government.
Today marks 34 years since the nascent NRA army under the leadership of President Yoweri Museveni, comprising of mostly young men and women in their twenties and early thirties captured Kampala in a victory that their leader and incumbent President Yoweri Museveni described as a ‘fundamental change’.
Challenges in the health services notwithstanding, the ruling NRM government over the past 34 years has achieved monumental landmarks in the health sector key among others reducing infant mortality to below 60 per cent, triggering universal immunization culminating in the eradication of polio and measles, putting close to 1 million Ugandans living with HIV/AIDS on ARVs, rehabilitating, re-equipping and building of new health centres up to sub-county level (80 per cent) and policy and regulatory framework that has encouraged the private sector participation in the provision of health services.
When the NRM-government took over power in 1986, health was one of the most emphasized sectors, knowing that a healthy population contributes to the growth of the economy. It is among the six priority sectors of the government.
From the outset, there have been massive investments in the health sector.
By 1986, health sector systems and facilities had broken down, there were no drugs in health facilities, the health workers were few, there was no hierarchy in health facilities as it is now; from health centre II up to the national referral hospitals.
There were only general hospitals and Mulago, and there was no nomenclature attached to them. There were a lot of preventable diseases; especially immunisable diseases.
President Museveni immediately re-launched the immunisation program in 1987 that only covered 34% at the time.
The NRM government also took over at the time when a high burden of Malaria, and HIV had just come in was rapidly rising with a prevalence of over 18%.
Looking at the 34 years of NRM government, the health sector has registered tremendous achievements confirmed by the increase in the life expectancy of Ugandans from 45 to 63 years.
This according to officials translate into more productivity and thus increased contribution to economic growth.
Also, Museveni, the administration found the infant mortality rate at 150 deaths per 1,000 live births. Today, it has dropped to about 43 deaths per 1,000 live births. For children under five years of age, the mortality rate was equally high; at over 90 deaths per 1,000 children, but it has dropped to less than 54. Although, this is still high compared to other countries in the region.
The maternal mortality rate was at 505 deaths per 1,000 live birth, but it has dropped to 336 per 1,000 live birth. This means that the country loses nine women every day due to labour and pregnancy-related issues; although, some statics show the number stands at 16 women per day.
The immunization coverage has increased from 34% to 95%, and the immunisable diseases have been increased from 6 to 13.
The increase in immunization coverage is the result of the decrease in the under 5 mortality rate.
These impressive statistics under his administration were reached at, as a result of systematic planning throughout the Health Sector Development plans since 1986.
The first Health Sector Strategic Plan addressed the burden of the disease that was very high. In countering this burden, there was a need to revitalise immunization, set up units to fight HIV/AIDS, Tuberculosis and Malaria.
The sector also massively addressed environmental hygiene and sanitation-program units were set up and National Medical Stores (NMS) was created too.
This Health Sector Strategic Plan One (HSSPI) paved away for HSSPII, whose main goal was to address access to health services by the population.
The government envisaged that if a population is within a 5km reach of a health facility, then they could easily get treatment. This resulted in the creation of Health Centre Twos, Threes, and Fours. To date, over 75% of the population is within a 5km reach to a health facility, and the remaining 25% are in a 2km reach.
This proceeded by the HSSPIII, which addressed community participation in their own health. This brought on board the Village Health Teams (VHTs). These were trained with the sole purpose of getting the communities to participate in their own health, but also emphasizing disease prevention and health education.
From the Health Sector Strategic Plan (HSSP), the Health Sector Development Plans (HSDP) were adopted. HSDPs are a consolidation of all HSSPs.
Over the 34 years of NRM government, the following achievements have been consolidated.
Part II runs tommorrow, Sunday January 26, 2020