In 1999, the Uganda government established staffing norms – a human resource planning tool that gives indication of the number and caliber of staff required in a given health facility.
Two decades later, the outdated norms are still being used to recruit health workers. They have not been revised to match the rapid population growth, the changing disease burden and rapidly changing global health situation. Uganda’s population has more than doubled from 21 million people in 1999 to over 40 million in 2019.
This is one of the disturbing revelations in a new report of the study titled ‘Health Workforce Financing in Uganda: Challenges and Opportunities’ that was launched on January 29,2020 by the African Center for Global Health and Social Transformation(ACHEST), conducted in partnership with Wemos, a global health advocacy CSO.
The report is part of ACHEST and Wemos’ contribution to the Health Systems Advocacy Partnership programme.
The findings show that despite efforts made by the Uganda government and its partners, the shortage of health workers still persists. Insufficientfunding and poor management of funds are the underlying factors that require to be addressed before the improvement and retention of health workers isrealized. The report also shows that the total health expenditure has been decreasing in the last decade. A large share of the health budget in Uganda is funded by development partners, yet in most cases, these funds cannot be used to pay health workers salaries.The delayed National Health Insurance Scheme process, means the household out of pocket spending on health remains high and catastrophic.
The report gives the following recommendation:
• Update the staffing norms of the health sectortaking into account the population growth, increasing disease burden of the country and internationally agreed standards. The on-going review of the Human Resources for Health Strategic Plan should prioritise the issue of updating the staffing norms.
• The training of health professionals should be adjusted to address the cadres that have highest shortages. Government should implement the WHO recommended Country Coordination and Facilitation (CCF) mechanism, that brings together the ministries of Education, Health, Local Government, Public Service, Finance and other relevant stakeholders to forecast and plan the training of health professionals according to needs. In addition, Government should ensure the timely disbursement of resources to the MoH, to facilitate fresh recruitment of trained and currently unemployed health workers to address prevailing staffing shortages.
• Government should reverse the declining per capita expenditure on health by incrementally moving towards the internationally recommended allocation of 5% of GDP to health.
• Government should expedite the passage of the National Health Insurance Scheme Bill to minimise the exposure of the population to the exorbitant cost of health care.
• The Government should undertake tax reforms to reduce leakages, tax evasion, unfair tax exemptions and capital flight. In addition, Government should expand the tax base by tapping into hard-to-reach economic activities, as well as improve efficiency of revenue administration mechanisms.
• Development partners should increase and expand support for health workforce development, including recruitment and salaries, through more flexible and dependable funding.The previously strong Sector-Wide-Approach(SWAps) in the health sector should also be revived.
Development partners should also increase the share of funds channelled through the Government and support the plan for a Joint Action Fund.
During the launch of the report, participants acknowledged that investing in health was crucial to a country’s gains.
The Ministry of Health represented by a member of the Human Resources for Health technical working group said the ongoing human resources strategic planning would address challenges in leadership management ,performance, induction, registration of health workers and professional development among others.
Find the link to the report here********