Prime
Health promotion is the way for our health system
Author: Douglas Kaziro. PHOTO/COURTESY
What you need to know:
- The country definitely faces increasing challenges in the health sector due to rapid population explosion.
Health is a critical part of our being because when we get it right, every other pursuit follows suit. In this article, I am addressing myself specifically to physiological health and with the advent of Covid-19 pandemic and Ebola outbreak that surged through the country, a discussion on health has never been timelier! No doubt Uganda’s health sector, like others, too, continues struggling to hold itself together.
The sector has a total of 6,937 health facilities across the country. These facilities are responsible for provision of health services to an entire population estimated to be 43 million. I am not being political in any way whatsoever, but visiting most government facilities, the strain is visible.
The country definitely faces increasing challenges in the health sector due to rapid population explosion. The doctor to patient ratio is 1:24,725, which makes it harder for patients to have appropriate services from medical workers, especially doctors.
With private facilities paying slightly better than government, this has only abated the predicament as most private hospitals are located in urban areas hence further scarcity of medical personnel in rural areas.
If there is any lesson that we should have, as a country learned from the waves of the indiscriminate Covid-19 pandemic and Ebola, it should be the urgent need to enhance our health system.
The rich and poor alike, we all struggled to access the health facilities whose capacity to absorb the overwhelming patient numbers was not anywhere near satisfaction, and yours truly having been a patient of the same, I felt compelled to pen down these critical ideas.
One of the feasible ways of reducing the burden of overcrowding in health facilities is the advancement of health promotion approaches.
This calls for Ministry of Health paying more attention on strategies that improve health citizenry knowledge, attitudes, skills and behaviour within given communities; to address and prevent the root causes of ill-health, for prevention is better than cure!
Standard operating procedures such as wearing of masks, handwashing with soap, sanitising, and physical distancing that were used to fight against Covid-19 are visible components of health promotion. Health promotion should be deliberately and strategically handled as a complementary drive to common efforts.
Fragile health systems such as ours benefit more in such strategies of disease control and prevention that try to deal with the situation at individual level before getting the disease, which in turn reduces the pressure on the health facilities and health workers.
Though, there is evidence of increased allocation of resources, the growth in the health budget has not been matching the overall growth in the budget. Even before Covid-19, the health sector budget had begun to decline as a proportion of the total budget, from 7.06 percent in 2018-2019 to 6.11 percent in 2020-2021, with a slight increase from 6.1 percent in 2020-2021 to 7.73 percent in 2022-2023, but still below the Abuja Declaration target of 15 percent spending as per the UNICEF 2022-2023 budget brief. Much as primary healthcare receives the lion’s share of the health sector budget, singling out and focusing more on health promotion as a social mobilisation strategy for health of individuals will save our health system a great deal. Government needs to put more emphasis on health promotion strategies, more focused funding to the sector and capacity building of the technocrats at the national and district levels.
Village Health Teams, whose mandate is to mobilise communities for health programmes and strengthen the delivery of health services at household level, should be well remunerated and trained to adequately relay information to communities. Essentially, they play a double role; service and promotional functions.
This way, we will have literally enhanced the performance of our health sector lest we forget who we are—a critically fragile healthcare system and economy, of course, to the peril of our own progress and existence.
Mr Douglas Kaziro is a health promotion practitioner.
