Tuesday, September 9, 2014

Uganda's 2014/15 budget ‘out of step’ with voters’ health priorities says Poll

Press Release

(KAMPALA) Civil society organizations working for access to essential health services in Uganda today released new data on Ugandan voter priorities revealing that during the course of the 9th Parliament, health has surged forward as the most prominent voter priority—more important than crime, education, or unemployment.

Moreover, the research revealed the vast majority of voters will not support an MP who does not prioritise health issues, such as correcting medicine stock outs or increasing health financing. 

CSOs called for MPs to take action based on these data, specifically that Parliament not approve the FY2014/15 national budget unless it includes dramatically scaled up investments in recruitment and motivation of front line professional health workers, alongside expansion in primary health care (PHC) funding for health facilities.

“A nation of sick Ugandans cannot benefit from economic development,” said Dennis Odwe, Executive Director of AHGA Uganda (the Action Group for Health, Human Rights and HIV/AIDS).

“These data show clearly: MPs cannot ignore the health priorities of their voters. Without expanded funding for these priorities, pregnant women will continue to suffer preventable deaths and complications, people with HIV will wait in line for life saving treatment, and Ugandans will continue to suffer without access to essential health services. For too long, health workers have toiled without adequate remuneration, leading to demotivation, attrition, and lack of accountability for poor quality service delivery.”

Coalition members also demanded an increase for PHC funding—the resources health facilities use to pay for electricity, clean water, fuel, and other priorities. “The Current PHC non-wage recurrent funding levels are only 41bn instead of the required 82bn,” said Samuel Senfuka of White Ribbon Alliance for Safe Motherhood Uganda.

“Government is failing to deliver on its commitment to ensure access to emergency obstetric care in all Health Center IVs, and women are dying as a result. Our health facilities cannot respond to the leading causes of preventable maternal death—post partum haemorrhage, sepsis, obstructed labor, unsafe abortion and eclampsia—unless they are equipped to provide essential health services. 

Government must match their promises with the funding levels needed to save the lives of pregnant women, newborns and children.”

The 2014/15 Budget Speech indicated that “government will enhance health workers’ remuneration and improve their skills through capacity building” and that “health facility infrastructure at both local government and referral levels, will also be expanded, in addition to the construction of additional staff houses in lower level health facilities to minimize absenteeism.”

However, according to civil society, it is unclear what portion of the UShs 450 billion announced for enhancement of civil servants’ salaries will be invested in health workers. UShs 215 billion is already ring fenced for a raise in teachers’ pay; civil society is calling for the balance of UShs 235 billion to be invested in production, recruitment and retention of front line health workers, particularly priority cadres such as midwives working at Local Government health facilities.

Civil society called for government to expand funding for HIV treatment as well, consistent with prior years’ increases. 

“This year’s budget proposes a flat line in funding for lifesaving anti retroviral treatment,” said Margaret Happy of the International Community of Women Living with HIV Eastern Africa (ICW EA).

“Yet more people are waiting in line for treatment because Uganda has changed the clinical eligibility criteria so that more people with HIV can benefit from the clinical and prevention benefits of treatment. We call on government to increase investments in HIV treatment by 50%. Civil society is recommending:
(i) Dramatically enhancement PHC by 41.2bn in the priority areas of administration of health facilities to cater for immunization, supervision, coordination, hygiene inspection, and health education.
(ii) Prioritized enhancement of wages for midwives and other critical cadres of the health workforce is estimated to cost UShs 13.3 bn
(iii) Completing the recruitment exercise of 3,371 health workers a will cost UShs 28.3 bn in annual salary and allowances.
(iv) Increasing investment in HIV and TB treatment by 50% to UShs 150 billion.
For more information, contact: Dorcas Amoding, AGHA Uganda, 0782585305
Asia Russell, Health GAP, 0776574729

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