A call for more holistic information, support at community level


According to the national health accounts statistics for the financial year 2015/2016, only 19.9% of the expenditure by health care providers was used for preventive care.


By Dr. Elizabeth Ekirapa

As we prepare for World Health Day, I have been pondering about how we can improve the health of Ugandans.

It reminded me of the words of the former Director General Prof. Omaswa that health is made at home and repaired in hospitals.

We seem to prefer to repair health rather than to build it at home. The financing of health services and the human resources for health are all geared more towards curative care than preventive care and yet it is estimated that 75% of the illnesses in Uganda are preventable.

According to the national health accounts statistics for the financial year 2015/2016, only 19.9% of the expenditure by health care providers was used for preventive care.

If we are thinking of making Ugandans healthy, preventive care needs to be prioritised. A huge amount of the financial and human resources spent currently on providing curative care can be saved.

Furthermore, with increasing non-communicable diseases such as diabetes, cardiovascular disease and cancers, a more resource saving option cannot be ignored. Failure to prevent these illnesses is contributing to premature death and lost productivity as a result of illness.

When you link this discussion to family planning, the story is the same, our population growth rate of 3% is among the highest in the world.  We could be able to reduce the population growth that is overwhelming the existing financial and human   resources with regard to the delivery of all kinds of social services if we increased the uptake of family planning services.

The list is endless, but let me cap it here, I hope you are convinced that this needs to be high on our agenda. But what exactly should we do? The Sustainable Development Goal three aims at promoting health and wellbeing for all at all ages, to achieve this we need to bring together actors from all sectors. They need to harmonize actions that can address the different social determinants of health. For the purposes of this article, I will focus on just one issue.

I applaud the work of the Minister of Health and permanent secretary in championing the agenda of community health systems strengthening in Uganda. We need to direct more resources towards building health at home by providing holistic information and support that can help communities take the recommended actions to prevent ill health and promote good health. This would include basic actions such as ensuring that all their children are immunized, they have latrines, sleep under a mosquito nets, wash their hands after visiting a toilet etc.

We need a well thought through a community system that can provide this kind of holistic information to improve both the health and well-being of people at the household level. In addition, tracking of those at high risk or who need facility based care and referring them to a functional facility system through an efficient functional referral system is also necessary. This of course calls for more prioritization and funding not only for primary health care activities but also for sectors such as education, agriculture, water and sanitation which impact directly on health.

Dr. Elizabeth Ekirapa- Health Economist –SPEED project and Chair of the Department of Health Policy, Planning and Management


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