KAMPALA —The Ministry of Health and Twaweza are coming together to share critical information about Ugandans’ health-seeking behaviours amid significant case numbers and fatalities from Covid-19 in the country.
Twaweza collected data from citizens across the country and residents of Kampala, Kyotera and Tororo to understand opinions and experiences of health services in Uganda.
The most recent data were collected nationally in December 2020 from 1,590 respondents and from 768 residents of Kampala, 639 residents of Kyotera and 622 residents of Tororo in June 2021.
Twaweza has been collecting data around citizens’ knowledge, opinions and behaviours around Covid-19 since May 2020 to support government efforts to combat the pandemic.
Ugandans have been concerned about their health facilities and what it means for their health and well-being since long before the Coronavirus hit the country. In December 2019, 4 out of 10 citizens (42%) named health facilities or diseases as the country’s main challenge, more than mentioned any other issue. In December 2020, close to half of Ugandans (46%) said the same.
Citizens also named unemployment (33%) and the high cost of living (31%) as significant issues. Both of these have also been named by more citizens when compared to December 2019.
Several issues have also dropped in the citizens’ priority list in 2020 compared to 2019, including corruption, poverty and the gap between rich and poor, water, crime, and education.
When they have health challenges, most Ugandans (56%) turn to government health facilities. This proportion has increased from 51% since 2017. At the same time, the use of private or NGO facilities seems to be decreasing: in 2017, 24% of Ugandans mentioned visiting a private or NGO facility compared to 17% in 2020.
One out of ten citizens (12%) sought medicine either from a pharmacy (6%) or the grocery (6%) without first visiting a health facility.
However, there are differences between rich and poor and urban and rural citizens when it comes to their response to illness or injury.
Wealthier Ugandans and those in urban areas are much more likely to use private facilities than poorer or rural Ugandans.
Among wealthier citizens, 3 out of 10 use private facilities (29%) while 2 out of 10 urban Ugandans (22%) do so compared to 12% of poorer citizens and 16% in rural areas using these facilities.
But Ugandans face a myriad of challenges when using government health facilities. The most significant problem is a lack of medicine mentioned by 48% of those who personally visited a government health facility to seek treatment or care. Other issues cited include long waiting times (29%) and a lack of respect from staff (20%). All other challenges were mentioned by fewer than 1 out of 10 people, and 1 out of 3 Ugandans who used government health facilities (33%) say they did not encounter any problems.
When asked what they would do and who they would contact in case of a suspected case of Coronavirus, residents of three hotspot districts have similar views. In Kampala (78%), Kyotera (83%), and Tororo (88%), more than 8 out of 10 residents would visit a health facility if they got sick.
The next most popular option is to self-isolate at home, although less than half as many residents of the three districts say they would do this if they got sick. Staying at home is more popular in Kampala (38%) and Tororo (28%) than in Kyotera (19%).
The third most cited action that residents of the three districts would take if they suspected they were sick is to use herbal remedies or local medicine: this is most popular in Kampala (28%) and to some extent Kyotera (22%) but not mentioned by many in Tororo (7%).
Violet Alinda, Twaweza Uganda Country Lead and Director of Voice and Participation, said, “Covid-19 forces us to look at our greatest vulnerabilities as a country and to address them in the long term. Our health systems, livelihoods and access to water all need urgent attention to prevent this and future pandemics and to ensure Ugandans are healthy now and in the future.”
Dr. JB Wanaiye Nambohe, Commissioner Emergency Medical Services said, “We are pleased to see increased uptake of government health services. Ugandans are expressing growing confidence in the government’s ability to take care of their health needs. At the same time, they remain very concerned about their health and livelihoods. As we deal with the ongoing coronavirus pandemic, we are also working on sustainable, long-term solutions to the country’s major health challenges.”