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Winning Essays May 2024: Uganda Health Systems

Welcome to the May 2024 edition of the Uganda Youth Essay Competition. This month, we focused on the critical topic of the Ugandan Health System and explored innovative ways to further improve it. We received a multitude of insightful essays from talented young writers across the country, each offering unique perspectives and solutions. After thorough evaluation, we are excited to announce the winners who have demonstrated exceptional analysis and creativity in addressing the healthcare challenges in Uganda. Join us in celebrating their achievements and contributions to this important discourse.

Winner: How Healthcare Systems In Uganda Can Be Further Improved – Charles Okello | 17 | St. Mary’s College Kisubi

Improved health care systems have a realistic ability of raising the dead. Throughout the course of my lonely childhood, I had the desire to have a sibling I would play with. Fortunately, I learned that my mom had conceived. I willingly participated in taking care of her during the time of gestation. The lucky day of delivery that we all anticipated finally came. 

We rushed her to the hospital where we were asked to pay money on arrival. None of us had money and she was not insured. Besides that, the hospital did not have the state of the art equipment for safe delivery and the midwives were on strike due to poor pay. Unfortunately, the baby was left to die. 

In this essay, you will be enlightened about the challenges facing Uganda’s health care system and four most important strategies to conquer the challenges. They include;

Innovation. 

This denotes new, better and more effective ways of solving problems. The WHO defines innovation as a concept that improves efficiency, effectiveness and quality of health services. The Ministry of Health should develop health innovation hubs. Health innovation hubs are research hubs where trained professionals collaboratively convene to conduct health research. They entail quality equipment, quality technology and improved resources for experimentation.

Health infrastructure. 

This is the foundation of public health care from vaccinations to chronic disease prevention programs to emergency preparedness. Uganda should improve on the workforce ratio from the current 1.7 per 1000 population to the required 2.5 per 1000 population. Additionally, there is a need to improve the salaries of health workers and employ information systems like electronic medical records(EMR).

Funding. 

From delivery to training health professionals to insurance schemes, this is the engine of any health care system. The government should widen the tax base to collect more revenue and stop spending unnecessarily. There is a need to increase Uganda’s health expenditure per capita to the required $84 from the current $54. Government should cut expenditure on other sectors and improve health funding by 8%.

Lastly, sustainability. 

This is meant to cater for the future health care needs of the less fortunate and all citizens. The government should provide Medicare and Medicaid insurance schemes. The Medicaid to cater for citizens below the poverty line and Medicare for citizens over the age of 65. It should also ensure that all citizens that are employed can have employer insurance. This is to ensure that there is provision of quality health care. With time, the life expectancy can then increase to over 65 years.

In conclusion, the government should have a greater focus on improving innovation, health infrastructure, funding and providing a clear health insurance scheme to tackle the challenges affecting the health system. There is no perfect health care system but the world changes, people change and so the health care system must be adjusted in order to resurrect my young brother.

1st RunnerUp: Improving Healthcare Systems in Uganda Abraham Tumwine | 18 | Seroma Christian Highschool

In the event of health related issues, the quote ‘it is health that is real wealth’ by Mahatma Gandhi certainly comes to mind. Healthcare besides being the ultimate wealth is an important aspect of human life and society that sadly and unfortunately is poorly developed on the African continent. The COVID-19 pandemic of 2020-21 shed light on how the African continent and Uganda inclusive had gaping holes in their healthcare systems.

Despite the improvements to the Ugandan health sector compared to past years, it’s still facing considerable problems especially in the finance sector. The portion of the budget allocated to health almost doubling since 2016/17 hasn’t reduced the problems the sub-Saharan country is currently facing. The reduction of the budget allocated to the pharmaceutical sector from 42% in 2019/20 to 34% in 2021/22 despite a significant population increase is one of the many examples of improper planning by the country’s leadership. Another similar example is the fact that more than 80% of the health budget goes to personnel costs leaving other sectors unattended. The ensuring of proper allocation of funds by the government can therefore help to improve the healthcare system.

The high influx of the health budget to personnel hasn’t helped to reduce the high rate of health workers attrition with 30% leaving the sector per year and 50% leaving in the first five years. The poor working conditions of health workers in Uganda include little pay, poor working conditions, limited chance of promotion etc. have led to Ugandans leaving the profession for greener pastures and brain drain. The country should put more energy into implementing the Human Resources for Health Strategic Plan 2020-30 that looks to improve the working conditions of workers hence improving their retention in the health field. The government should also provide incentives to health workers in rural areas to encourage the diversification of health workers in both rural and urban areas.

Synonymous to most African countries Uganda inclusive, an underdeveloped infrastructure has had its effects hard felt especially in the medical field. The poor roads, insufficient medical facilities and many more have led to overcrowding, poor sanitation and an increased patient-to-bed ratio in health facilities. The reduction of the budget allocated to developing infrastructure especially in the primary health sectors has worsened conditions. The government should set up programs to improve the infrastructure and purchase of up-to-date medical equipment especially in rural areas where their lack has been more felt.

National Health Insurance Schemes should also be implemented by the government to reduce the burden of out-of-pocket medical expenses that have left Ugandans in poverty with some selling property to finance their medical needs. For the notion of health being wealth to come to realization, the government has to change its mode of operation and their stance towards the health sector has to be prioritized. It’s only then that the government will erase the name that has tarnished its health sectors and make top-tier healthcare systems a reality.

2nd RunnerUp: Pending Ugandan DreamsClaire Namyalo | 24 | Kyambogo University

It is commonly said that health is wealth.

I wish the same could be said about my land,

Located within the core of the once called dark continent,

Reigning supreme in the heart of the East,

My country stands out like a precious gem: likened to a shiny pearl.

It is, and there will only be it, spreading the heartbeat all around,

my country, our homeland and mother, Uganda.

Born and raised in this mighty land, corruption and greed have I observed,

pain and torture have I witnessed; through the lenses of it’s inhabitants.

The health sector alone is a victim of this malicious vice.

The cries of the laborers echo out aloud.

Not paid for their service, their numbers only a handsome left; outmatched

to serve the demanding: explosive masses as numerous as the grains of sand.

Faulty equipment lie in wait for a redeemer, limited supplies to use.

All these are necessities required to ensure safety of their lives.

They are people, our people; and their lives matter.

Though willing to help, stand down in protest;

As a means to fight for their rights: and those of their dependencies.

For this cause they are forced to look aside, as a means to secure their lives.

But in the long run, victims are dragged into this war, innocent lives are lost. It is sad,

quite painful to lose a life that could have been saved.

And low and behold, cries, bitterness and tears are all left to remember.

But what should be done?

Like medicines sooth a wound: and so are early payments to those in service.

Besides their work, families look to them, responsibilities engulf them and daily

demands never part ways, clinging to them endlessly maybe till eternity.

And so, this solution alone could calm the storm.

Give it a try you will see, one day you will thank me.

Other than that, hospitals cry out; make me clean,

I need enough room for myself and everyone within me.

I need more medicines, equipment, supplies;

These people need the best service for what they are worth.

Fix me and everything I need, don’t stop; not even the sky’s the limit.

For our people, medicines aren’t the only solution.

Before drugs arose, nature was the only remedy.

Though this is still the case, nature is still the ultimate solution.

Eat natural foods, do exercises, keep fit; the natural way.

Digging, running, fetching water; all these: free of charge yet keep you vibrant , alive for life.

Give these a try, it won’t hurt and worth a try.

As we part ways, remember; have hope: that one day, all turn around.

Corruption will cease and greed will just flee,

All this will feel at ease, our people will be released and finally free from all dis- ease.

This is the Uganda we look forward to, numerous miles for us to walk to,

And when we arrive; we will all look back, and gladly say; this was worthwhile.

Honorable Mention 1: Pain – Merveille Kasangandjo | 24 | Kyambogo University

Pain, I always thought it was just a four-letter word, short and simple, easily pronounced even by a toddler. But that day, I realized that pain is more complex than it seems. It varies depending on the person experiencing it. 

For the past four days, I’ve been confined to my bed. I can’t move, I can’t speak. People come and go, attempting to communicate with me. I wish I could find the words to describe how I feel. It hurts; the pain is overwhelming. 

Three days ago, I woke up full of energy, happiness, and excitement for the day. The next thing I remember is being struck by a car, and everything changed. I was taken to the hospital, bleeding and in pain. Two hours later, my head is pounding, my clothes soaked with blood from my chin wound. However, nobody came to help me. Finally my family members arrived, alarmed and worried as they examined me. I tried to stand up, but I only ended up back in my seat. My entire body feels numb. “Oh my god, Merva, you’re bleeding so much! Why haven’t they cleaned your wounds?” my mom cries out, visibly anxious. 

My mom, who is usually composed, had a look of fear on her face as she rushed to the reception. “All our patients are required to make a payment before they can see the doctor,” I hear her say for the tenth time since I arrived. 

Looking into my mom’s worried eyes, I can’t help but cry. It’s all my fault. Living as refugees in Mbarara is already challenging, and even finding enough food is difficult, let alone paying for hospital bills. 

With each passing second, the pain intensifies. It feels like this might be my last moment. I begin to feel the full extent of my injuries. Everything hurts so much, and I want to scream for help, but it’s in vain. “Please, let her see the doctor while we find the money. At least let her have a painkiller to stop the bleeding,” my mom pleads. “I’m sorry, it’s hospital policy. I wish I could help,” the receptionist responds. By this time, I’m struggling to stay conscious. My family keeps trying to persuade her, but it’s futile. 

Finally, the money is paid. Now I’m stuck in the hospital waiting for more tests. I can’t help but think, it has been a terrible experience. The delay in receiving help only worsened my pain and awakened my trauma. As a refugee, it’s difficult to afford healthcare. I wish things were different, and everyone could receive the care they need. 

In Uganda, we need to make healthcare more accessible. Money should not be a barrier to receiving help. We should find a way to assist refugees and ensure that everyone can afford medical treatment. No one should have to suffer because they can’t pay. I hope things change, and healthcare improves for everyone in Uganda.

Honorable Mention 2: Steps To Improve Healthcare System in Uganda – Nyangoma Joanitah | 20 | Bishop Cypriano Kihangire SS Biina

According to WHO, a health care system is one that consists of all organisations, people whose primary intentions are to promote, restore or maintain health. The elements of a health care system include private insurance model, Bismarck model, National insurance health service.

The major aim of Uganda’s health system is to deliver the national minimum health care package. Uganda runs a decentralised health system with national and district levels. Uganda’s health care system consists of both private and public health care providers. It has around 6940 health facilities of which 45% are government owned, 15% are privately owned not for profit and 40% are private for profit. 

The government has made some effort to improve on the health care system in Uganda however more is still needed to further improve on the healthcare system in Uganda so as to achieve a healthy Uganda. 

The following can be done to meet this cause

Through improving the medical education system, the health care system in Uganda can further be improved. The lack of medical education is still a problem as the majority of the physicians and nurses don’t receive sufficient training. As a solution to this the government can fund medical students to go for further education and training in other countries like India, Canada.. and this will improve the quality of medical services delivery.

Through further improvement on the infrastructure , this can further improve on the health care system in Uganda. These include roads, hospitals, among others. Despite the fact that Uganda has made some effort to improve on its infrastructure over time, more effort is still needed. 

The government has at least ensured a health center per region however the roads are still a hindrance and this has made it very hard especially for pregnant mothers to reach the health facilities in time to give birth, and this has increased the infant mortality rate in Uganda thus improving the roads can easy the transportation of patients and medical equipment to the health facilities

Further improvement on technology can also improve the health care system in Uganda. This can be through use of machines which increases efficiency and improves the quality of drugs produced.

Through further privatization of public health facilities , can also improve the health care system in Uganda. This increases efficiency due to the high levels of close monitoring . This can ensure provision of high quality health care services.

Fighting corruption can also improve the health care system in Uganda . This will ensure proper allocation of resources meant for the purchase of medical equipment and intended use rather than personal gains.

Through implementing laws to check the standard of drugs produced and administered. This can reduce the number of quacks and improve the quality of drugs given to the sick people.

In conclusion therefore, the government of Uganda needs to use the already available resources and measures in order to further improve on its healthcare system

Honorable Mention 3: Mental Health in Uganda – Winnie Atugonza | 14 | Mt. St .Mary’s College Namagunga

Mental Health is the state of one’s mind. Uganda’s current major health issues are vaccine-preventable diseases, epidemic-prone diseases, diarrhea, sexually transmitted diseases, and mental health illnesses among others. However, mental health illnesses tend to go unnoticed and are slowing causing the health of Ugandans to depreciate.

In a Monitor article six months ago, Tony Abet stated that one in three Ugandan’s minds are in poor conditions. In a health study done, he quoted, “Anxiety and depression were very common.” This is already a call to Ugandans to prioritize their mental health because there are serious repercussions.

Psychology states that the mind works in a formula, one will think, one will feel and lastly one will behave. We should be worried about that last stage because irrespective of trauma, depression, anxiety, or anger the results are never positive. The results are portrayed in Uganda today!

Mental and behavioral conduct is probably half the cause of violence in Uganda. These people weren’t brought up safely, the conditions in Uganda are not the best and hence we don’t tend to have the best citizens mentally.

Occupations such as psychologists and psychiatrists should be embraced by the youth today because my research tells me that every psychiatrist is one million Ugandans to be attended to. This means that many Ugandans’ mental health is being ignored.

With more emphasis on mental health, I’m sure that Uganda will be able to get somewhere. Our country mustn’t stay ignorant. A healthy mind is a healthy soul.

THANK YOU

Interested in New Challenges