On October 30, 2020, the Health Systems Advocacy Partnership (HSAP) country partners held a live TV discussion on health systems strengthening.
This was to reflect on the last five years (2016-2020), that the HSA has been in existence.
The project has been implemented by Amref Flying Doctors/Amref Health Africa, the African Centre for Global Health and Social Transformation (ACHEST), Health Action International (HAI) represented in Uganda by the Coalition for Health Promotion and Social Development (HEPS-Uganda), Wemos and the Dutch Ministry for Foreign Trade and Development Cooperation.
The project has contributed to the realization of sexual and reproductive health and rights (SRHR) of people in sub-Saharan Africa through building the capacity of civil society actors and health stewards with knowledge, technical skills and tools that are needed to develop and implement evidence-based advocacy strategies.
A two-hour talk show was hosted on NTV Uganda on 30th October 2020 and streamed live on social media, attracting over 200 viewers. The partners shared experiences and lessons learnt through the five years of HSAP. They also shared opportunities for improved human resources for health, Health financing, access to health commodities and improved service delivery.
ACHEST’s programme manager, Paul Gabula called for the need to accelerate progress towards the achievement of Universal Health Coverage targets.
He urged sub saharan countries to increase domestic resources allocated to SRHR.
“We have development plans, and we have sector plans. The plans are well set out, with clear indicators, but when it comes to financing these budgets, the money comes from donors. This .compromises the pace at which we do activities,” observed Gabula.
He added: “ The COVID-19 pandemic also compromised how much money would be put into Sexual Reproductive Health. The funds have been shifted to other priorities like COVID19. This compromises the pace at which we are moving.”
It should be noted that in 2017 a study undertaken by ACHEST in seven African Countries revealed slow progress towards Sustainable Development Goals. The study undertaken in Ethiopia, Kenya, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe pointed out the need for countries to embrace Intersectoral Collaboration to accelerate the achievement of the SDGs. “We need to step up,” said Gabula, citing this study.
HEPS-Uganda’s Executive Director Denis Kibira stated that although the Uganda government has made strides, the health budget was not growing at the same pace with the population.
“In Uganda, about 40% of out of pocket health expenditure and slightly over 40 % is by donors, the government is paying only about 15 %. We need to ensure that we pool funding so that we are not paying as and when need for a service arises.”
Kibira called for the need for a health national health insurance scheme and placing a tax on items perceived to be harmful to society such as cigarettes and alcohol.
“The money from these taxes would go to health. Accidents also account for a lot of our health budget. There should be a means to look into the transport industry to finance health,” suggested Kibira.
On human resources for health, the partners said graduates must have skills that match the needs of the population.
“The rate at which we are producing health workers is not matching the population growth. They for instance need to know how to handle a client from a rights based perspective. If it is difficult for a young person to report an STD because the health worker will ask why didn't you abstain. The health workers needs to be in tandem with the needs of the community,” said Patrick Kagurusi, AMREF Uganda
ACHEST’s Gabula also remarked: “ There are too many medical institutions, how are they being supervised and regulated? Who is ensuring that the quality of health workers churned out will address SRHR issues. Is there need to review the current curriculum to address the needs of the population?”
Also highlighted was the importance of governance and leadership and mindset change to implement integrated people centered primary health care in communities as the pathway to UHC .
Other panelists on the show were Dr. Orec Isaac, Senior Medical Officer Lira district, and Fred Tabu, a country consultant for Results for Development.
Watch the detailed conversation on the NTV Youtube channel, titled “Ensuring protection of the gains achieved under Health System Advocacy program: https://www.youtube.com/watch?v=AX-aPfX28cE&t=17s