Uganda’s ailing Health System challenges Catholic Church's innovation

By Valerian Kkonde

PEARL NEWS SERVICE

As Ugandans continue to grapple with a life-threatening health system due to neglect and corruption,  the Catholic Church has come up to devise means of ensuring that its medical facilities are up and running, providing health services that uphold human dignity and at the same time are self sustaining.

This was the gist of the Uganda Catholic Medical Bureau (UCMB) Annual General Meeting at Youth Sharing Centre, Nsambya from 21 to 22 March. Convening under the theme: Sustainable health financing: A call for Innovations, the Catholic Health Services Network was responding to the current economic crisis that has seen the drastic reduction in the amount of funds contributed by donors towards the running and maintenance of these facilities.

“Financing of health services through traditional means is becoming difficult. We do not want to lament but recognize these challenges and find a way forward.

“We need to change our way of thinking and working. Performance-based financing is the most likely way to go,” said Dr. Sam Orach the Executive Secretary of UCMB.

Dr. Orach revealed that staff turnover, because of low pay, was the network’s biggest challenge. He said that they spend a lot of money on training but that every time they visit the facilities they find that 50% of staff is new.

 “This undermines quality.”

Orach stressed that the difference between the Catholic Church health facilities and the rest is that “ours is a mission entrusted to us by our Lord Jesus Christ.” Talk of a healthy body and a healthy soul.

Catholic Health facilities fall under the “Private Not For profit” (PNFP) health services. The Catholic Health Services Network comprises of hospitals, health units, health training schools, diocesan health departments and the health Commission of Uganda Catholic Episcopal Conference.

According to Dr. Orach, UCMB had by December 2011 registered 73 Health Centers II, 170 Health Centers III and five Health Centers IV. Hospitals registered with UCMB totaled to 30.

Sources of funding for these health facilities include donors, customers and the government. Donors contributed 44% while user fee contributed 40%. Government contributed a meager 16%.

“If government can provide more support, the user fee will be reduced. If not, our hospitals will find means to offer services and survive,” Orach revealed, adding that only 21% of resources is from local contribution.

With 31% of Ugandans earning below US $ 1 a day, health facilities are clearly beyond the reach of many. The demise of Ugandans has been complicated by the economic crisis pounding the globe, leading to the closure of many purses that have been subsidizing the health system.

To this add corruption, selfishness, incompetence and bad governance that the government is exhibiting and the fate of Ugandans is as good as sealed.

This scenario calls for urgent devising of ways that will enable the Catholic Church health facilities find means of sustaining their activities which are not profit–driven, but after upholding the dignity of the person.

Healthcare in Uganda was started by the Church. The Protestant missionaries constructed Mengo hospital in 1887, and the Catholics started Lubaga hospital in 1889. To date Church health facilities continue to hold the healthcare flag high.

 Mulago, the only National Referral hospital, has failed to give hope to patients; it has become a place of increasing their misery. Regional hospitals cannot provide basic medicines like panadol yet hardly a year passes without drugs rotting in government stores.

But all is not lost. UCMB is the only local Organisation pioneering initiatives in Patients Safety as part of quality improvement. The Bureau is developing a quality and patients safety manual. On the use of ICT, Dr. Orach revealed that enhancement of the project had delayed due to legal consultations.

However, all the health facilities are networked. Installation of the Video Conference is ongoing and the Annual General Meeting narrowly missed being the first activity to be held by video conference.

The Electronic Patients Register Management for hospitals is also being worked upon. The website is pending completion. Dr. Orach confirmed that the funds are available.

Commending the practitioners for a job well done amidst all sorts of challenges in the ministry of Christ, Bishop Egidio Nkaijanabo the Chairman of the Health Commission urged them to care for one another.

“As this Annual General Meeting comes at a time of Lent, get some insight from the Pope’s message which calls for a life of love and good acts to others.”

Bishop Nkaijanabo further called upon the health workers to avoid putting their institutions and the Catholic Church into disrepute by what they do.               

 On innovating options for the financing of PNFP health services, Dr. Everd Maniple – senior Lecturer Uganda Martyrs University- proposed “commercial activities detached from the medical services.”

Dr. Maniple proposed that the Network takes to research and manufacturing. Under manufacturing, he said that the Joint Medical Stores could start with generics and then go to research and development.

The other was the IT services like a healthcare database. He added that Ambulance systems could also be a great innovation especially in urban areas. Maniple further proposed that entering into Partnerships with big medicine manufacturers and advertisers could be a rewarding venture.

Maniple also thought of getting loans as well as ensuring better access to government funds.

But according to Fr. Emmanuel Katabaazi of Masaka diocese, the small health units should first consolidate their financial management, that way they will be able to sustain themselves without needing outside funding.

“Good financial management is essential for sustainability.”

The Secretary General, Uganda Catholic Episcopal Conference, Msgr. John Baptist Kauta warned the members against engaging in acts “that destroy the good reputation of the Catholic Church health facilities.”

Msgr. further urged them to “be truthful and ensure you are good stewards; spend on what you are supposed to do. When you fail to account for the funds received, you are simply saying that you do not need more funds.”    

Commending the Health Commission for being the most active, he too warned the health workers against being carried away by the income-generating projects to the extent of being diverted from their work as that would turn the projects into tumours.