As part of the advocacy strategy under the Health Systems Advocacy Partnership; African Centre for Global Health and Social Transformation (ACHEST), Amref Health Africa and Health Action International (HAI) represented by Coalition for Health Promotion and Social Development (HEPS) organized a fact finding visit for representatives of the Parliamentary Forum on Quality of Health Care Services.
The six days (4th to 9th July 2018) fact-finding mission was based on four objectives and these included:
(1): To follow up on health worker absenteeism in an earlier research finding; (2): to ascertain stock levels for SRH commodities in the selected facilities; (3): to find out governance issues affecting the delivery of quality health care service; (4): and to assess the working conditions of health workers and its impact on quality of health service care provided.
The field visit followed a petition by a group of CSOs to the speaker of Parliament on the status of health care services that was tabled on May17th 2018. The HSAP partners in Uganda therefore found it appropriate to support the legislators to carry out targeted visits to four sampled districts in the Central, Northern and Eastern regions and in the districts of; Bukedea, Lira, Mubende and Mityana.
A snap shot of the findings included: Staff absenteeism: it was found out that lack of staff accommodation including poor quality of houses, low levels of supervision, task shifting, lack of motivation of staff in lower level health facilities had an impact on staff attendance and therefore compromised the quality of service delivery.
Sexual Reproductive Health Commodities: there were consistent stock outs of some essential commodities such as syringes, gloves, Oxytocin and ART Septrin across many facilities; including supplies like blood pressure machines and weighing scales for babies.
Leadership and Governance: This is a big challenge in many lower level health facilities where for instance, staff and Health Management Committee (HUMC) meetings were not frequently held and HUMCs are not oriented on their roles after being appointed. The staffing levels are not all filled, but amongst the filled ones, some staff are on study leave which widens the unfilled gaps.
Working conditions: Most of the health facilities had poor working conditions; for instance, some delivery rooms had cracked walls with no delivery beds, no blood pressure machines, no gloves and syringes, most facilities had no fences, no security personnel and no running water and electricity as well.
Recommendation: There is therefore need for policy revision to address the regular stock outs and filling the staffing gaps including revisiting the old staffing norms that no longer serve the needs of the increased populations efficiently. The national funding budget to the health sector needs to be increased but of critical importance is the need to strengthen Leadership and governance of the health care systems to harness all the other building blocks.