According to the budget framework paper for 2017/18, government has proposed budget cuts to several sectors.
The health sector is set to suffer a nominal cut of 30 per cent from Shs 1.8 trillion in FY2016/17 to 1.2 trillion shillings in 2017/18. Speaking at the 31st National Resistance Movement (NRM) liberation day held in Masindi district, President Museveni said the money set aside will be used to expand and strengthen the transport infrastructure as well as for construction of the oil refinery ahead of the anticipated oil production set to begin in 2020.
In energy and infrastructure, the president and, indeed, the government have a point. The roads will facilitate trade and movement of people. The country is bound to benefit from oil production too. But here is where government priorities are questionable.
You do not have to kill one of your daughters to take care of another; you can nurture them both especially that the ruling party prides itself in increasing domestic revenue collections from Shs 500 billion in 1986 to over Shs 11 trillion shillings today. By cutting the health budget, government is killing her daughter to take care of an anticipated pregnancy. It is a worrying development, which will terribly affect mothers the most.
On February 7, 2017, a 23-year old mother in Mityana died of excessive bleeding as she reportedly went unattended to over lack of Shs 5,000. This is not an isolated incident. Such cases have been reported before across the country.
In a country where a life is lost over lack of one pound, shouldn’t government instead allocate money to operationalize a national health insurance scheme which would benefit the poor mothers who cannot afford the absurdly-expensive private health services?
The year 2020, when Uganda anticipates oil production to begin, is the same year the country is expected to have contributed to realising a very critical global health development milestone, an additional 120 million women and girls worldwide able to access rights-based family services.
FP2020 Progress Report, Momentum at the Midpoint, released in 2016 noted that demand for family planning services in Uganda is growing with modern contraceptive prevalence rate at 24.4 per cent, up from 20.6 per cent in 2012.
Access to modern family planning services is one of the most realistic household-level ways through which poverty can be eradicated. It improves the quality of life of women as mothers can appropriately determine when to have children and how many to have.
Cutting the health budget will reverse these gains as monies to provide information and procure family planning commodities will be reduced. Already, the midwives, who are central in the provision of family planning services, are in inadequate number. According to the Uganda Nurses and Midwives Council, the country has only 6,000 licenced midwives.
The World Health Organisation recommends one midwife to care for 175 births per year; therefore, about 9,000 midwives are needed in Uganda. With only 6,000 licenced, the country has a deficit of at least 3,000 midwives. Midwives are critical for the health of mothers and their babies.
They care for these mothers right from the point of conception, during antenatal visits, in actual labour and administer postnatal services. Any gaps in this process due to inadequate skilled health workers is detrimental.
The National Development Plan II is centred on delivering the country to a middle-income status. That means reducing poverty or increasing people’s incomes. For that to happen, strategic investment must be made today, not tomorrow.
We should not cut monies to the health ministry to finance socio-economic development programmes. Rather, we should invest in health, for improved quality of lives of people leads to reduction in healthcare bills, which savings can be invested in socioeconomic development projects.
Government should focus on making investment in attracting, recruiting, motivating, and retaining health workers and ensuring they are equipped with the knowledge and skills to provide quality healthcare services.
Uganda cannot afford cutting health budget allocation which is still way below the minimum of 15 per cent of the total national budget set by the Abuja Declaration, to which Uganda is a signatory.
The author is the executive director, Education & Development Opportunity.