Wednesday, February 18, 2015

Members Decry Poor Medical Services in Lira

MPs, Chief Administrative Officer Lira District and WRA Lira members in maternity ward at one of the health centres visited 

Source: Parliament of Uganda Website- http://www.parliament.go.ug/new/index.php/about-parliament/parliamentary-news/534-members-decry-poor-medical-services-in-lira

Members on the Parliament Committee on Health were shocked when they realized that all the theaters in health center III and IVs in Lira district are dilapidated and non-functional. This was during  the committee’s  fact finding field visit to Lira health facilities following a petition to Parliament on the low status of life-saving emergency services for pregnant women and newborns by the community of Lira district. The petition was laid on table by Lira district woman Member of Parliament Hon. Joy Atim Ongom on 15th July 2014. 

The committee was amazed to discover  that the accommodation facilities at the health centre III and IVs were abandoned and no single health worker was present  at Anyangatir and Barapwo Health Centre III. Lira District Health Officer Dr. Kusolo Peter noted that as a result, patients prefer to go to Lira Regional Referral Hospital which has led to over congestion in the hospital especially the labor ward. 

Hon. Lematia Ruth who is the Vice Chairperson of the Parliament Health Committee noted that  Uganda can prevent maternal and newly born deaths by ensuring that  women have immediate access to basic and comprehensive life-saving emergency services in the health Centers.  She stressed that  99 percent of all maternal deaths are preventable since the causes are known.  She added that the continuous death of women and their newborns is a sad reminder that Uganda  not doing enough to prevent the death of women during pregnancy and childbirth.

Lira district woman Member of Parliament Hon. Joy Atim Ongom who is also a member of the committee noted that government has to ensure that enough funds are budgeted to improve on the infrastructure and employ qualified health workers in all health centres. She urged women, husbands, families and the community, to involve themselves in maternal health issues so that women feel safe while giving birth to life.


Hon. Dr Twa-twa Jeremiah holding and checking a maternity register joined by other MPs and WRA Lira Chairperson (in navy blue midwifery/nursing uniform) at Ogur health centre IV. Photo by Denis Okwir-WRA-Ug Trained Citizen Journalist

Tuesday, February 10, 2015

Graft claims hit Uganda medic export scheme

Medical staff at the Butabika National Referral Hospital in Uganda. PHOTO | FILE |  NATION MEDIA GROUP
By Julius Barigaba
Even as Ugandans await a ruling on the temporary injunction to stop the government exporting over 250 health workers to Trinidad and Tobago, it has emerged that the recruitment was riddled with corruption.
Amid reports that unqualified people paid up to Ush7 million ($2,456) to be shortlisted, Kampala became wary of a backlash from the Trinidad and Tobago government. It placed advertisements in the media to isolate people cited in bribery claims ahead of a thorough screening of the shortlisted workers.
Last August, the Ministry of Foreign Affairs shortlisted 450 doctors, nurses and midwives drawn mainly from public health institutions to be exported to Trinidad and Tobago on three-year contracts. Sources say officials from the Caribbean island nation will travel to Kampala “anytime soon” to help with the selection of the final 263 health workers who have the required skills. 
A source familiar with the recruitment told The EastAfrican that, among this number, there are unqualified people who bribed their way into the shortlist. 
“People who are not qualified doctors or health workers paid to get shortlisted,” the source claimed. “Are you surprised? This is Uganda.”
‘No bribery’
But Foreign Affairs Ministry spokesman Fred Opolot said if indeed the claims are true, the victims should come forward and name the perpetrators of the fraud.
“We ran adverts and said that people making these allegations should come to the Ministry of Foreign Affairs and the police and file official complaints but no one has come forward,” said Mr Opolot. “As far as we are concerned, we don’t know of any bribery in this exercise.”
In November last year, The EastAfrican reported that the Institute of Public Policy Research (IPPR) had sued the Attorney-General, seeking to block medical worker exports to the Caribbeans by the Foreign Affairs Ministry.
The High Court will rule on March 2 on the case, in which IRRP’s lawyer, Justinian Kateera, argues that “besides being contrary to public health policy it is also unethical, irrational and unconstitutional for Uganda to deny its own citizens the much-needed health workers.”
On February 5, a coalition of about 40 civil society organisations also issued a statement questioning the logic of the Ministries of Foreign Affairs and Health to export medics to a country whose health indicators and patient-to-health worker ratios are way higher than Uganda’s.
“The government should be ashamed,” said Sam Senfuka of White Ribbons Alliance Uganda. “They are supporting the export of our most prized resource — our health workers, who are in scarce supply in the health system.
“Export should only be considered if a country has a surplus; this is basic economics. We have thoroughly analysed this plan; it is wrong-headed and must be stopped.” 

Friday, February 6, 2015

Civil society opposes health workers’ export

WRA Uganda's Robina Biteyi News Interview with Amuka na BBC. Full Swahili bulletin here http://www.bbc.co.uk/swahili/medianuai/2013/11/000010_amka_na_bbc


By Alfred Wandera & Esther Bulyaba


A coalition of civil society organisations has added its voice to the criticism against Government’s move to export about 300 health workers to Trinidad and Tobago.

Addressing a joint press conference Thursday in Ntinda at Action Group for Health Human Rights and HIV/AIDS (AGHA) offices, the health activists demanded that Government stops defying its own evidence and substantially increases investment in the health sector.

The activists’ protestation comes barely a week after the Institute of Public Policy and Research (IPPR), a local think-tank, sued Government in what it says is one of the first ever public interest litigation cases concerning a medical "brain drain".

“Government should be ashamed. They are supporting the export of our most prized resource – our health workers – who are in scarce supply in the health system and are a national treasure,” said Sam Senfuka of White Ribbon Alliance Uganda in a joint press statement.

“Export should only be considered if a country has surplus; that is basic economics. We have thoroughly analyzed this plan and it is wrong headed and must be stopped,” added Senfuka.

Joshua Wamboga, the Executive Director of Uganda Alliance of Patients Organization (UAPO), said the implementation of the plan would increase suffering and preventable death in Uganda especially among pregnant women, newborns, HIV victims, tuberculosis and malaria victims and other leading causes of preventable death. 

“Government should be increasing health workers’ remuneration, improving working conditions and increasing the wage bill so that our clinics are finally saturated with motivated health workers. Instead, our duty bearers are defying their own evidence and want to actively support health workers to leave. We will not allow this to happen,”     said Wamboga.

Wamboga explained that their preliminary analysis of the Government plan indicates that any remittance generated by health workers exported overseas would fail to compensate for the economic costs associated with catastrophic illness and increased rates of death.

Uganda Nurses and Midwives Union (UNMU) president, Janet Obuni, said Uganda has failed to live upto the Abuja Declaration’s call for African states to allocate 15% of their national budgets to the health sector, leaving the sector in a sorry state.

“Uganda’s health budget is between 8 and 9% of the total national budget, which is way below the Abuja Declaration standard. We have a heavy disease burden but government is not investing in the health sector. Uganda’s current doctor to patient ratio is 1:15, 000; nurses to patient is 1:7, 000 and midwive to patient ratio is 1:9,000. This is against the World Health Organisation’s (WHO) required ratio of one doctor to 1500 patients, one nurse to 700 patients and one midwife to 1000 patients,” said Obuni.

Claire Mugisha, AGHA Advocacy Programme Officer, said the current national estimate of the quantity of health workers stands at 40,67 nurses and midwives and 4, 449 doctors, serving a total population of 35 million Ugandans.

Joyce Lucy Atim, UNMU national treasurer, claimed that some of the people listed on the Ministry of Foreign Affairs website are not qualified health workers, arguing that they were recruited following influence from their relatives and friends in the Ministries of Health and Foreign Affairs.

Ministry of Health Permanent Secretary, Dr. Asuman Lukwago, said the reason why Government decided to use the Ministry of Foreign Affairs to recruit health workers for export to Trinidad and Tobago is because it is foreign relations 
affair.

However, Lukwago said the Ministry of Health was involved in the selection process through the Health Service Commission.

“Those questioning the credibility of the shortlisted health workers have no competence and authority to do so. They can only come out to speak about it after consulting us,” said Lukwago.

He added that the decision to export health workers is aimed at arresting the scenario where most of them have drowned in the Mediterranean while trying to cross to overseas in search for green pastures.

“We don’t know how many health workers have died in the sea trying to cross to Europe and other developed countries. What government did was a formalization to make sure that things work out for them legally instead of them risking their lives,” said Lukwago. 

Source, New Vision: http://www.newvision.co.ug/article/fullstory.aspx?story_id=664520&catid=1&mid=53&utm_source=twitterfeed&utm_medium=twitter

Friday, December 19, 2014

Walking for the Mother: Support for Maternal and Child Health Care



WRA members with their banner joined other citizens to walk for the mothers through the streets of Kanungu District Town. Photo by Cyprian Ntale

Report by Cyprian Ntale
WRA-Ug member
Kanungu District


Members of White Ribbon Alliance (WRA) for Safe Motherhood Uganda in Kanungu District participated in a charity walk dubbed "Walk for the Mother," to raise funds to support Rugyeyo Community Health Center in Kanungu District. The walk, which is part of the annual International Community of Banyakigezi meeting slated on 27th-28th December 2014, began in Kampala on December 6th (1st walk) and later went to Kanungu District on December 13th 2014. 

Kanungu District in south west Uganda will host this year's meeting with participants coming from all the four districts which make up Kigezi region i.e. Kanungu, Rukungiri, Kabale and Kisoro.


WRA members participated in both walks aimed at raising Shs 50 million. Professor Mondo Kagonyera and Rt Hon Prime Minister Dr Ruhakana Rugunda who was represented by Hon. Chris Baryomunsi were the chief walkers in Kanungu and Kampala respectively. Among other guests were; Bank of Uganda Governor Tumusiime Mutebile, Hon. Jack Sabiiti, Hon. Roland Mugume Kaginda and Mr Garuga Musinguzi. About Shs 25 million was raised at both walks.

Participants in the Walk for the Mother march in Kanungu to raise funds for a community health centre ahead of International Community of Banyakigezi Uganda chapter convention due on 27th December 2014 in Kanungu. Photo by Cyprian Ntale

Under the Saving Lives at Birth Project, WRA-Ug works together with AMREF Health Africa in Uganda and We Care Solar to light up health facilities with solar power, raise awareness and create demand for maternal and newborn health services and strengthening the health system in Kanungu, Kisoro, Rukungiri and Kabale districts.

Monday, November 24, 2014

Public health facilities lack resuscitation devices, newborn deaths high- study

Publish Date: Nov 15, 2014  
Public health facilities lack resuscitation devices, newborn deaths high- study
The commissioner clinical services at the ministry of health, Dr Jacinto Amandua addressing participants during the meeting. PHOTO/Agnes Kyotalengerire

By Agnes Kyotalengerire                     

Majority of public health facilities are lacking basic equipment to resuscitate newly born babies leading to a high number of newborn deaths, a study has revealed.
The report also indicates that in the few health centers where there is equipment, medical workers do not know how to use them.

 “We lose babies who are born tired and cannot breathe because the health facility lacks equipment to resuscitate them,” said Barbara Zalwango a midwife working at Bulera health center III in Mityana district.

Resuscitation devices help to revive babies who fail to breath at birth a condition referred to as asphyxia.

The devices include: an ambu bag (neonatal bag) and mask, suction bulb and a training mannequin.

The study follows a survey that was conducted by White Ribbon Alliance Uganda in three pilot districts of Lira, Mityana and Kabale on the availability of newborn resuscitation devices has shown that most of public health center III and health center IVs lack equipment for resuscitating newborn babies.

Even where the equipment is available, health workers lack the skills to use it.

The national coordinator White Ribbon Alliance for Safe Motherhood Uganda, Robina Biteyi said none of the three districts met the minimum requirements for resuscitation of the newborns which leads to high number of newborn babies dying.

The study findings were revealed  during a stakeholders meeting organized by White Ribbon Alliance for Safe Motherhood Uganda on creating an enabling policy and  implementation framework for procurement , distribution  and availability of newborn resuscitation devices at Golf Course Hotel in Kampala  on Tuesday (yesterday).

 The district health officer Mityana, Dr. Fred Lwasampijja said the cases of newborn death in the district are alarming.

Dr Lwasampijja estimated that in a month about ten newborn babies die due to failure of midwives to resuscitate them when they are born distressed; tired and cannot breathe.

“These are few facility deaths but the number could slightly go up because some babies die at home and the cases are never reported to the health facility,” he said.


Dr. Victaria  Masembe working with WHO (left), the district health officer Mityana, Dr. Fred Lwasampijja(center) and the commissioner clinical services at the ministry of health, Dr Jacinto Amandua during the meeting at Golf Course hotel. PHOTO/ Agnes Kyotalengerire.

Bateyi said procurement of newborn resuscitation devices by ministry of health has been largely dependent on project by donors.

"Health centers cannot order for devices when they need them and mainly have to rely on the ministry of health to buy the devices when there is a funded project," she said 


 What the ministry of health says

The commissioner clinical services at the ministry of health, Dr Jacinto Amandua said with improvement in maternal and newborn health, focus is going to be put on acquisition of maternal and newborn equipment especially for resuscitation and also for helping mothers who have problems during delivery.

“The ministry is going to work with national medical stores to procure equipment for the public health units in addition to supplying medicines,” Amandua said.

He said procuring of resuscitation devices is only one aspect but it is important that every health facility has a skilled midwife to ensure the lives of mothers and newborns are safe.

Newborn mortality in health units is unacceptably high contributing to about 50% of deaths in children under the age of five years.

 According to the study, out of the nine health centers in Lira, only three had newborn resuscitation requirements.

In Mityana, out of 12 health facilities assessed, only 7 had the devices and in Kabale district 19 out of the 22 health centers had the devices.

This situation puts the lives of newborns at risk of death.

According to the Uganda Demographic health survey 2011, a total of 106 newborn babies die every day due to preventable causes.

Of these, 26% die on the first day of life due to failure to breathe and maintain breathing a condition referred to as asphyxia.

President of Uganda private midwives association, Mary Gorret Musoke said the ministry of health should plan with various stake holders to know how much is needed for each health facility, create a budget line for procurement of these devices and train the human resource to use the devices.

 Basic requirements for a labor suit

The president elect, association of gynecologists of Uganda, Dr Jolly Beyeza said a mother in labor should be attended to by two midwives; one extra to give a helping hand in case the baby comes out distressed.

Secondly, there should be a labor bed where a mother labors from, a delivery bed, a delivery kit with all the instruments required for conducting a delivery,  a resuscitation table with all the devices with a light up on the table to keep the baby  warm.

A partograph is also required to monitor the progress of labor, fetal heart.

Monday, November 17, 2014

Citizen Participation in Budget Monitoring and Expenditure Tracking Requires Access To Information

Senfuka Samuel 
info@wrauganda.orgbsenfuka@gmail.com

Mr Keith Meeting WRA team in his office. Photo by Faridah Luyiga
Faridah Mwanje after handling over WRA materials to Mr. Keith
Budget Transparency and Accountability: WRA-Ug meeting with Mr. Keith Muhakanizi Permanent Secretary/Secretary to the Treasury-Ministry of Finance, Planning & Economic Development. The aim of the meeting was to discuss a collaboration for making budget information available and accessible to citizens especially at district level. This is in line with WRA's citizen empowerment approach to monitor and track budget expenditures for Emergency  Obstetric and Newborn Care services at      their health centres.

"Ministry of Finance is happy and ready to partner and work with WRA and CSOs and provide all the necessary budget information. Our goal is to ensure that citizens are aware about their budget so that they are able to hold us accountable on fund releases and expenditures by ministries and districts," Muhakanizi pledges.

Ministry of Finance in the FY 2014/15 identified Budget transparency and accountability as one of the key interventions to strengthen institutional governance, accountability and transparency in public service delivery. Other interventions being undertaken to improve service delivery include:
  • Publication of quarterly fund releases to ministries and Local Governments (both online and print media)
  • Decentralization of the pay roll for civil servants
  • Creation of a Uganda Budget Information Website, meant to enable citizens to access budget information of  resources allocated and utilized up to the local level 
  • The ministry plans to establish an SMS platform and a phone Hotline for public feedback on budget utilization
  • The ministry also conducts quarterly and annual budget monitoring and accountability through its Budget Monitoring and Accountability Unit and at effective implementation of Government programmes and projects.  


All the above are well-intentioned interventions to improve budget accountability and transparency but the question we should all ask ourselves is-how many people (citizens) are aware of these opportunities so that they can effectively participate in their budgets monitoring and expenditure tracking? It is often challenging to the community members to access budget information especially at district and sub-county level under the guise of confidentiality! Citizens need to be empowered to know their rights to access such information but also to use it in executing their obligation of monitoring and tracking utilization of the funds.

Ministry of Finance, Planning and Economic Development should strengthen the budget accountability and transparency by investing in grass-root budget information dissemination and empowerment of citizens with skills to monitor the budgets and tracking expenditures.

#ActNowToSaveMothers #Accountability#Transparency #CitizenParticipation#MaternalHealth #Commit2deliver