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Health budget much better, but…

Patients at Kiruddu hospital

Health advocacy groups have commended government for allocating more funds to the health sector in the recently released budget.

In the budget speech read last week, the ministry of Finance approved Shs 1.853tn for 2016/17 for the health sector from the previous Shs 1.227tn in 2015/16.
That was an increase of Shs 626.55bn

Patrick Ojulong, the programme officer, Action Group for Health Human Rights and HIV/Aids (AGHA), said the health sector has been underfunded for long but the recent increase is a sign that things are going the right way.

“As NGOs, we thank government for the improved health sector budget allocation; although the increment is welcome, more money is required to match needs especially in areas at primary health care,” he said.

Ojulong was addressing a press conference at AGHA offices in Ntinda last week. He said government should fast-track efforts to operationalise the Aids Trust Fund (ATF) this year by enacting its regulations.

According to Ojulong, the fact that the country does not have an Aids Trust Fund is risky because in case the donors pull out, HIV patients may fail to get sufficient ARVs.

“As you know, 50 per cent of our HIV/Aids interventions are done by external funding, if the donors decide to withdraw, we will be in trouble because we don’t have a special fund,” he said. “It’s high time the government took responsibility on Aids without depending on donors.”

Denis Odwe, the executive director, AGHA, said examining the intra health sector budget reveals a “top heavy” budget; for instance, resources are being concentrated more at the headquarters rather than the bottom tier where they can be easily accessible to communities.

In the current budget Ministry of Health headquarters controls about Shs 1.0 trillion (55.8 per cent) of the sector budget while districts have an allocation of Shs 320.1 bn (17.5 per cent).

“Media coverage especially during presidential candidates’ tours brought to light the issues of public hospitals’ lack of hygiene, inadequate manpower and medicines [coupled] with ailing patients and  dilapidated structures.” Odwe said. “We urge government to undertake more strategies aimed at improving health service access to communities.”

Martha Kawala from Uganda Network of Aids Service Organizations (UNASO) proposed that government enhances primary health care non-wage allocations and increases its operational funds.

“The ministry estimates that an additional Shs 35bn for primary health care can enable health facilities operate at a reasonable level; so, we urge government to make that a priority in the subsequent budgeting,” she said.

Procurement of antiretroviral drugs

Diana Tibesigwa, advocacy officer, DSW (Deutsche Stiftung Weltbevoelkerung), said the World Bank estimates the HIV/Aids prevalence rate is proportionately higher among key populations.

“The country has a funding gap for ARVs of Shs 151bn, in order to adopt and roll out the 2013 treatment guidelines that shifted treatment starting point from 350 to 500 CD4 [count],” she said.

She further explained that the increased enrollment of clients into the treatment pool has seen the costs of treatment and care go up. The advocacy groups asked government to fast-track efforts to operationalize the National Health Insurance scheme necessary for providing much-needed affordable access to health care, and ensure that the sector does not heavily rely on external financing.

“We recommend that government makes a first call on the next budget for the National Health Insurance scheme by ensuring that Shs 5bn startup capital is provided to cater for staffing, mobilization, sensitization and promotion of the scheme,” Ojulong said.

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