Masaka Diocese Remains Faithful to Catholic Health Mission amidst Host of Challenges

by Valerian K. Kkonde

PEARL NEWS SERVICE

 

Kitovu Hospital has become a household name for its excellent services in treating for free and restoring the dignity of women suffering from fistula. 
UCMB Photo

Found in the Southern part of Uganda lying West of Lake Victoria- the world’s second largest fresh water Lake- and very near the Equator, Masaka Diocese is characterised by high temperatures and heavy rainfall ranging between 625- 1100 mm per year.

Due to environmental degradation, these seasons are changing drastically. Apart from Sembabule where some farmers practice cattle-rearing on a large scale, and Kalangala where palm oil-growing is replacing fishing as the main source of income, majority people practice subsistence farming subjecting them to abject poverty.

Cash crops include coffee, maize and beans. Households also participate in rearing goats, pigs and cattle. Others participate in poultry.

The Diocese covers nine political districts including Masaka, Lwengo, Kalungu, Bukomansimbi and Kalangala. Others are Lyantonde, Kyotera, Rakai and Sembabule. They range between 11,000 and 15,000 meters in altitude.

The 2014 Uganda Population and Housing Census indicates that this area has an estimated population of 1,890,693.

According to Dr. Joseph Herman Musiitwa the Chairman Diocesan Health Board, the 2016-2017 data collected from 29 diocesan Health Units indicates that the Diocese has remained faithful to the Mission of the Roman Catholic Church while providing Health services.

Dr. Musiitwa states that every achievement, however minimal, is a great fit given the host of challenges in the field and bearing in mind that profit is not their primary concern.

The Diocese owns 32 lower level units. It also has two hospitals: Kitovu and Villa Maria. Of these, 19 are at the level of Health Centre 111 and 12 are at the level of Health Centre 11. Only St. Joseph Kyamulibwa is at the level of Health Centre IV. It also owns Kitovu Mobile a non-facility based AIDS organisation with its headquarters in Masaka Town and operating in five districts.  

Faithfulness to the Roman Catholic Church Mission is mainly measured against four major indicators: Access, Equity, Efficiency and Quality. Performance of these health units is measured against these indicators.

The report indicates that access to these facilities has improved by 2%. In terms of Equity or affordability, the meridian user fee has continued to increase in the last ten years due to the cost of inputs including medicines, employment, transport and power.

“Health units increased fees to fill the gaps created by the rising operational costs, reduction in external donations and the Primary Health care Conditional Grant. It is feared that the services at the Diocesan Health units will eventually become financially inaccessible to the users especially the poor.” Dr. Musiitwa observes.

In terms of technical professional efficiency, where the staff has to produce more and more standard unit of output without compromising on quality, lower level units were less efficient.

Quality of service improved as compliance to the generally accepted standards set by the Diocesan health units improved from 79% to 84.4%. All the Diocesan lower level units met the criteria for accreditation.  

The qualified staff ratio improved from 61% to 62%. It was also found that eight out of 25 units can fully provide Emergency Obstetric Care services compared to the eleven out of 27 units in the previous years.

“This decline is due to the absence of equipment needed to perform the service at the different units.”

While the drug prescription practices improved, the antibiotic rate was high at 27% against the WHO maximum of 15%. But the patient’s satisfaction improved from 79% to 83%.

In the governance, management and accountability structures, an improvement has been registered in financial management from 86% to 90%. In financial audit, units improved from 77% to 90.5%. With the implementation of performance management, the number of units appointing staff formally and giving job description has increased 31% to 64%. This has been boosted by training on how to make staff appraisals.

The Diocesan Health Department successfully organised a Diocesan Health Assembly to conduct a self assessment and suggest a way forward to ensure relevance and sustainability. It attracted officials from the Ministry of Health, district officials in the region, Diocesan officials, Health unit administrators and managers among other partners.

The Diocese however is faced with a big challenge of staff remuneration. It has no sure source of income for the Diocesan Health Officials. It also lacks sufficient and modern office space.

Lack of computers and a reliable and fast internet connection is another major impediment in the Diocese’s quest to provide affordable, accessible and quality health care. Reliable means of transport are also a big challenge.

The Diocesan wholesale pharmacy, for improving access to quality pharmaceuticals has continued to improve.  But space for storage of the pharmaceuticals is becoming insufficient.

“There is need for an additional store to accommodate the increasing volume of pharmaceuticals received and supplied.”

The Diocese has decided to partner with a number of institutions so as to provide reliable and relevant health services. It has partnered with Mildmay Uganda to support Human Resource Project and the DREAMS Projects for reducing HIV infections among adolescents and young women.

Other partners include the Catholic Medical Bureau, Life Net International, Joint Medical Store and Ministry of Health among others.

Doctor Musiitwa maintains that for the Diocese to sustain the achievements registered and bridge the gaps identified, a lot of effort is needed to improve resource mobilisation, ensure adherence to the policy documents and increase the frequency of support supervision visits to the health centres and do strict monitoring of the strategic plan 2017-2021.

“That is the sure way of keeping the Diocesan Health Units relevant to the community.”