By Winfred Ongom and Kasule Ahmed
White Ribbon Alliance Uganda under the Health Systems Advocacy Partnership (HSAP)project convened a meeting with Members of Parliament (MPs) and Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) coalition members on November 27th 2017 at Golf Course Hotel in Kampala. The aim of the meeting was to deliberate on key issues that should be prioritized in the budget for FY 2018/2019, regarding human resources for health and sexual reproductive health commodities.
The RMNCAH coalition partners presented a civil society position statement titled; ‘Accelerating progress towards achieving FP2020 targets and ensuring adequate human resources for health in Uganda,’ to the MPs.
The MPs were grateful for the platform because it helped them learn the key issues that need to be addressed. Hon. Okello Bonny mentioned the need to engage more with local governments because they are part of the recruitment and retention process of health workers. As Members of Parliament, they pledged their support for not only an increased health budget but also ensure there are resources availed for motivating and retaining health workers.
Hon. Monica Amoding who is also the Chairperson of Uganda Parliamentary Women’s Association (UWOPA) said they had been ‘silently’ supporting the doctors’ strike. She promised to raise the key issues that doctors are demanding and to support them in Parliament as soon as Parliament returns from recess. Hon Amoding also said that as members of parliament, they need support from White Ribbon Alliance and partners when they are monitoring service delivery in health facilities because they do not have the technical expertise necessary for some of the issues.
Dr. Patrick Kadama, the Director of Policy and Strategy at Africa Centre for Global Health and Social Transformation (ACHEST) stressed the need for revised staffing norms because the health worker structure currently used was meant to handle a population of the 1990s yet the population has more than tripled since then.
Dr. Nakabembe Eve, an obstetrician at Mulago National Referral Hospital emphasized the need to motivate and retain health workers. She mentioned that the entry into the health work force is narrow (getting in few new recruits), but the exit is wide (losing a lot of health workers), yet the population needs a skilled health work force. “What is important is to motivate health workers to retain them,” Nakabembe reiterated.
NMS explains challenges
Serious debate ensued when the General Manager, National Medical Stores (NMS), Mr. Moses Kamabare was put on the spot about expired drugs and drug/supplies stock outs at health facilities, problems that make it hard for health workers to treat patients. In defence, Mr Kamabare endeavored to explain the drug procurement and delivery process and requested Members of Parliament to always check the facts before casting stone. He requested them to cross-check the requests that health facilities submit to NMS against the delivery notes for these medicines and supplies from NMS. Kamabare also mentioned that deliveries are made in the presence of senior district leaders who can bear witness. He acknowledged that NMS still has some challenges, and asked MPs to avail her the resources necessary to procure sufficient drugs for all health facilities across the country.
Hon. Bagoole John concurred that he is aware some health facilities have challenges related to making proper requests for medicines and supplies to NMS. He however challenged NMS to address some of the key concerns that always keep coming up at health facilities. Hon. Akello Silvia, speaking on behalf of all the MPs reiterated that we [civil society] have their support and they are looking forward to sharing the information with the rest of the parliamentarians so that the health budget can be increased.
Donor commends dialogue
Mr Frank Van De Looij from the Netherlands Ministry of Foreign Affairs, who are financing the Health Systems Advocacy Partnership project in Africa, said he was happy about the discussions between the various stakeholders and commended dialogue as a great way of addressing challenges. He encouraged stakeholders to continue the dialogue to find solutions to the different challenges in the health sector.
The Head of Programs Amref Health Africa (also local sponsors of the HSAP project), Dr. Patrick Kagurusi reminded stakeholders that Uganda produces several highly qualified health workers, but ends up losing them to emigration. He further noted that even though Uganda has realized a reduction in maternal and neonatal mortality, we need to do more since we still have maternal mortality cases which we can prevent through a skilled and motivated health work force.
The National Coordinator White Ribbon Alliance Uganda Ms Robina Biteyi thanked the MPs for championing issues of maternal and child health in Parliament and requested them to use their oversight and budget appropriation roles to ensure that there are funds to support human resources for health.