No need for more benchmarking trips to pass Uganda National Health Insurance

By Esther Nakkazi

Each year parliament allocates 3billion Uganda shillings or USD $ 800,000 to the National Health Insurance Scheme (NHIS).

Uganda urgently needs an NHIS. It should be universal, fair, with only one pool, said Fredrick Makaire, the Executive Director, Save for Health an NGO that coordinates community health insurance schemes across the country.

After many years since it was first proposed, the Uganda NHIS is not operational although discussions about how it should be implemented are on going in Parliament and among stakeholders.

One of the activities for which the UGX 3 billion allocated is spent is the benchmarking exercise by members of parliament. This involves travel to different countries.

Twenty years since talks about starting the Uganda NIHS started divisions on whether the benchmarking is even relevant anymore are raising eyebrows.

Stakeholders are divided on the way forward. While some think the exercise is not relevant arguing that if the funds for benchmarking were to be saved they would have jump started Uganda’s NIHS by now others say ‘seeing is believing’ so the new members of Parliament need a physical assessment to support it.

Makaire says there’s no need for fresh benchmarking as there’s already enough data gathered over the last fifteen years.

Joel Ssebikali Yoweri, the Vice Chairperson of the health committee in parliament says the new members of parliament on the health committee who are 32 out of the 36 team need to get proof of how NIH systems work. 

Next month, for the fourth round of benchmarking 36 members of parliamentary health committee will visit Rwanda in December and proceed to Kenya and Tanzania in early 2023, participants attending the 6th National Community Health Financing two-day conference held in Kampala heard.

Previously, MPs visited Rwanda, Namibia, Ghana and France to benchmark for the bill that was passed by parliament in 2021.

However, the Bill was rejected by president Museveni who refused to accent to it.

The bill has been in parliament for four terms. The assessment is that there is zero political will to pass it. At some point it even disappeared and could not be tabled.

“It becomes embarrassing, as politicians we get ashamed when we talk about it. We have wasted government money because we benchmarked all over the world that money was wasted, efforts were futile and time,” said Ssebikali.

He advised stakeholders to start engaging smaller groups individually. “If we finish smaller groups without achieving this we shall be ashamed.” Financing healthcare in Uganda remains a nightmare. Maybe times Ugandans who go to hospitals come out poorer.

At least 1.5 million Ugandans are pushed down the poverty line because of health care expenditure. This was even more so amplified during the Covid-19 pandemic.

As well about 40 percent Ugandan households use out of pocket expenses to finance health care. The World health Organisation (WHO) recommends 15 percent out of pocket expenditure. 

At the East African Community level only Uganda and South Sudan lack an NHIS. Uganda has only 30.9 percent health coverage compared to Rwanda at 95 percent.

Now the Bill is back at the Ministry of Health for review. Dr. Charles Olaro, the Director curative Services in the Ministry of Health, says returning the Bill back to the Ministry of Health has enabled them to consult - engaging members of parliament, private sector and they have managed to get a consensus and a ‘win-win’ situation’ for most of the items that were not accepted. 

He noted that they are ensuring that everything that missed in the 2021 bill including the fate of community health schemes and private providers are well catered for in the new document.

Leticia Nakimuli Irumba, the Board chairperson, Save for Health Uganda says if the country puts all its resources in one pool we shall achieve universal health Insurance coverage.

“We are glad that we back and counting to advocate for the bill. We are sure that an opportune time we shall have the Bill signed.”

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Africa food cooling technology to be expanded

The African Centre of Excellence for Sustainable Cooling and Cold-chain (ACES) has announced at COP 27 that it will work with global cold chain provider Carrier to help advance cooling development and training in Africa.

“Turning food loss into nutritionally available food is essential for Africa’s sustainable development, as well as building the food systems that are used to feed people in times of uncertainty," said Toby Peters, Centre for Sustainable Cooling Director and Professor of Cold Economy, University of Birmingham and Heriot-Watt University.

Global leaders have recently agreed that the only way to overcome food insecurity is by working together to create innovative partnerships within the global community,” 

Carrier will collaborate in the development of the ACES cold-chain centre in Kigali, Rwanda - providing capacity building for farmers and refrigeration technicians, skills development for students and supply chain professionals, and demonstration of best-in-class sustainable cooling technology.

More than 475 million tons of the world’s food can be saved annually with effective refrigeration, and more than 50% of all perishable food loss could be avoided by using cold chain technology.

The University of Birmingham plays a leading role in ACES, which is developed with the Governments of UK and Rwanda and UN Environment Programme at the University of Rwanda.

Additionally, progress continues on the collaboration between Carrier, WFP and other leading companies to build a world-class Transport Training Centre in Accra, Ghana, aimed at enhancing transport and logistics capacities across West Africa. 

The centres are expected to inject new expertise into local transport markets, equipping them to deliver goods more efficiently throughout their respective regions.

 “We’re pleased to partner with ACES and WFP to make a meaningful difference across Africa, as the potential benefits of these collective efforts are far reaching and can positively impact the cold chain from farmers and manufacturers to consumers with wide-reaching benefits,” said Tim White, President, Refrigeration, Carrier. 

The University of Birmingham and the Indian State of Haryana recently signed a Memorandum of Understanding (MoU) to develop a Haryana Centre of Excellence on crop post-harvest management and sustainable cold chain.

The agreement builds on ACES and will conduct state-of-the-art applied research and provide capacity building and training, an innovation and business hub and technology testing/demonstration centre. 

It will connect experts, investors, agri-food business, farmer cooperatives, and energy or logistics providers to deliver sustainable cooling. 

It also follows an MoU signed earlier this year with the Indian State of Telangana for a Telangana Centre of Excellence. The UK and UN Environment technical assistance programme is funded by DEFRA.

Carrier is a leading global provider of healthy, safe, sustainable and intelligent building and cold chain solutions. 

ACES’ partnership will support Carrier’s focus on expanding the cold chain – improving health outcomes and reducing hunger, food insecurity and carbon emissions. 

ACES is being highlighted at COP27 through a series of side-events. Professor Peters will be presenting at the Clean Heating and Cooling Forum on Monday, 14 November. 

The event will explore policy, technology, and models needed across both the sustainable cooling and clean heat challenges.

As outgoing COP 26 President, the Rt. Hon. Alok Sharma MP, said when he visited ACES during CHOGM: “ACES is a demonstration of how we can work together, to help tackle rising emissions and keep alive the goal of limiting average global temperature rises. Cooling and refrigeration are the fastest-growing source of greenhouse gas emissions in the world, especially in developing countries. But this challenge gives us the opportunity to develop innovative, energy efficient technologies of the future.”

Orange Launches first 5G commercially in Botswana

Orange Botswana is the first Orange affiliate to launch 5G, with a coverage of 30% of the population, including greater Gaborone and Francistown. Other cities will follow in early 2023.

It follows the launch of Botswana’s first Orange Digital Centre this morning, which will help bridge the digital divide and prepare Batswana youth for employment in a blossoming digital ecosystem.

This 5G launch will further support innovation and digital inclusion in the country, putting Botswana at the forefront of 5G in Africa and is closely aligned with the government’s ambition to leverage Fourth Industrial Revolution (4IR) innovation towards transforming Botswana into a knowledge-based economy, leaving no-one behind.

Orange Botswana is the first Orange (www.Orange.com) affiliate in Africa to launch 5G commercially. New healthcare, education and security services will be enabled in the country by the 5G technology.

5G, with its ultra-high speed and low latency, will support new disruptive services such as e-health, connected vehicles, connected cities, real-time gaming, smart homes and learning through VR and augmented reality. 

It offers a new world of possibilities to companies, innovators and society at large.

Orange Botswana has partnered with MRI Botswana to create a “Connected Ambulance” project that will allow Doctors to guide Paramedics through life saving procedures on their way to hospitals. 

This telemedicine intervention will change lives and would not have been possible without 5G. Orange Botswana is looking forward to collaborating with government and enterprises to implement 5G-based use cases.

Orange Botswana introduces new 5G fixed broadband services and mobile data bundles. The offers are available for residential customers, small and medium enterprises and include value added services.

The fixed offers are available from15Mbps for Prepaid and from 20Mbps for Postpaid with a monthly rental from BWP 699 (€53 per month). The subscription of Prepaid offers is accessible through Orange Yame App, USSD and Card to Wallet.

In other countries, regulation boards still have not officially initiated the 5G licenses attribution process although many of them, such as in Cote d’Ivoire showed a clear will to make the 5G spectrum available in 2023.

Meanwhile, Orange is collaborating with several regulatory bodies to help build a 5G deployment roadmap while testing the technology and developing use cases that fit with the local populations’ need.

Africa: Of 23 countries studied only two-thirds publish data on bid opportunities

By Esther Nakkazi

Although one-third of government spending is done through public contracting, most African governments do not publish the information needed to track public spending on procurement, according to a regional analysis of 23 African countries conducted by the Open Contracting Partnership (OCP).

According to OCP research, while nearly all African nations analysed (91%) publish at least some information online, only two-thirds publish data on bid opportunities (65%) and 57%, publish data on who is awarded contracts.

“Over the last few years across Africa, many governments have struggled to procure, build, and institutionalise electronic government procurement systems despite tens of millions of dollars in headline Public Financial Management reforms from donors,” says Edwin Muhumuza, Head of Africa at Open Contracting Partnership.

The data is based on Fulfilling the promise of e-procurement reforms in Africa, OCP's latest comparative study on e-procurement in Africa provides guidance for making digital public procurement reforms more efficient, fair and transparent across the continent.

There is also the issue of how governments publish their procurement data. 

Only five African countries, Cameroon, Kenya, Nigeria, Sierra Leone, Uganda, publish data in machine-readable formats, dramatically limiting how the information can be used to ensure that public contracts benefit society as intended.

The analysis is based on the Global Data Barometer, an independent study of the quality and use of open data worldwide.Nigeria stands alone as the only country that publishes some data across the full procurement cycle including planning, tender, award, and implementation.

Transparency in public contracting is important because it is the main way governments hire companies to deliver vital goods, public services and infrastructure to citizens.

Bad procurement policies mean run-down roads, under-resourced schools and non-existing healthcare centers, and quite often, elements of state capture.

Transforming manual and often paper-based public procurement to electronic government procurement systems can make government more efficient, fair and transparent.

“Public procurement has a reputation as being bureaucratic, inefficient and wasteful,” says Muhumuza. 

“But doing it better is possible. And it’s critical if we want to make sure that government spending improves the lives of people. Our new report provides specific guidance and tools for governments implementing reforms and builds on best practices from the region.”

The report provides eight key recommendations in addition to practical tools built on the latest research by experts around the world as well as insights from practitioners in five countries – Ethiopia, Nigeria, Rwanda, Uganda, and Zambia.

National and county governments in five countries are publishing open contracting data, including Ghana, Kenya, Nigeria, Uganda and Zambia. Five more places have committed to open contracting reforms including Sierra Leone, South Africa, Tunisia, and the city of Tangier in Morocco.

"It will be important to build a coalition of change, comprising stakeholders from various parts of government as well as non-government champions, to overpower blockers so that enough winners accrue from the new system that ‘escape velocity’ be achieved, and the system is actually appreciated and used," says Muhumuza.

A procurement ecosystem has grown in Africa in the last decade. Investigative journalists such as Nigeria’s Dataphyte, civil society organizations such as the Uganda-based Africa Freedom of Information Centre (AFIC), and prominent anti-corruption campaigns in Kenya and South Africa have shown how public procurement data can be used to track money going into vital projects such as primary health care centers, schools and public works. This kind of civic monitoring ensures better value.

“Those leading e-procurement reforms need to engage civic actors, service beneficiaries and business stakeholders to build a coalition. A program of change needs to be designed and built ‘with them’ and not ‘for them’,” says Muhumuza, the author of the study.