|On the left is the Ministry of Health team and on the right a section of MPs listening to a presentation by CSOs during a Health Committee meeting at Parliament of Uganda|
By Senfuka Samuel
On Tuesday 19th February 2013, the Ministry of Health team led by Minster of State for Health (General Duties) Hon. Kataike Sarah, Permanent Secretary Dr. Asuman Lukwago and Director General of Health Services Dr. Jane Aceng presented to the Health Committee of Parliament a progress report on recruitment of 10,231 health workers as committed by government in FY 2012/2013. The minster reported that 5,707 health workers had been offered jobs countrywide as of 15th February 2013. In October 2012 during the national budget discussions, the Government of Uganda took a bold decision out of concerted advocacy efforts by Parliamentarians, Civil Society Organizations in health and other stakeholders to recruit 10,231 health workers for HC IVs and IIIs to avert a human resource for health crisis in the country.
According to the ministry report, 36,891 applications were received across the country, shortlisted, interviewed and 7,586 passed the interviews. As of 15th February 2013, the districts had offered 5,707 jobs and 1,533 reported to their duty stations.
The Civil Society Coalition to Stop Maternal Mortality in Uganda and the Coalition for Maternal, Newborn and Child Health on the invitation of the Health Committee also presented their key observations and recommendations that were based on information collected from the District Health Officers and District Service Commissions.
“The Ministry has made some measurable achievements despite the logistic and technical challenges encountered in the recruitment process. This time round the ministry of health has been very committed to ensure at least minimum staffing levels at health centre IVs and IIIs which are nearer to the majority of the people. In the subsequent financial year 2013/14 we ask ministry of health to make it a priority to enhance the wages of lower cadres such as midwives along with further non-financial motivation for medical officers in HCIVs.” Said Senfuka Samuel of WRA Uganda during a presentation to the committee on behalf of CSOs.
According to CSOs information from districts, some districts have failed to attract certain cadres and the ministry agrees with this. For instance Kabale district advertised 12 posts for medical doctors to fill vacancies in their six health centre IVs but managed to recruit only two, Bugiri district advertised 2 posts and failed to attract any. These HC IVs have gone for years without doctors.
A visibly sad Senfuka Samuel add that: “Most HC IVs lack functional operating theatres and lack or have inadequately skilled medical officers, unable to perform Emergency Obstetric Care (EmOC) and newborn care tasks yet a primary objective of establishing HC IVs was to provide facilities for comprehensive EmOC services such as caesarean sections and any other emergency surgery, blood transfusion.”
|Senfuka Samuel, WRA Uganda presenting on behalf of CSOs in health a report on health workers recruitment to the Health Committee of Parliament at Parliament as MPs listen.|
Ministry of health further highlighted some challenges encountered during the recruitment process some of which will require short term while others long term remedial solutions. For instance failure to attract enough applicants for certain posts e.g. out of the advertised 371 medical officers only 165 were recruited, 1,095 advertised posts for Clinical Officers only 749 were recruited, 1,371 posts for Enrolled Midwives were advertised and 745 were recruited, 449 Anesthetists posts advertised only 51 recruited and 229 posts for Theater assistants but only 54 were recruited. According to MoH some cadres of professional health workers are insufficient in supply because of no more production of such cadres like Theater assistants, anesthetic assistants or few institutions are producing them where as others are due to policy gaps. For instance Uganda stopped producing midwives in 2006 on the premise that the comprehensive nurses could be trained in both nursing and midwifery skills and perform a dual function. However, this has raised continuous debate and resistance from the traditional mainstream midwifery professionals and associations that comprehensive nurses do not have adequate skills and competences to perform midwifery functions hence they were denied an opportunity to apply as midwives in the recruitment drive.
Some districts did not have District Service Commissions in place which delayed the exercise hence reliance on the neighboring District Service Commissions.
Recommendations and way forward
- Ministry of Health immediately assesses the number and cause of gaps in the recruitment exercise, per District, and prepare in partnership with District officials remedial action to ensure all 10,231 qualified health workers are identified and deployed as quickly as possible. This should include immediate re-advertising of still-vacant positions and possibly those created as a result of promotions of health workers or crossovers to other districts
- Ministry of Health should make it a priority in FY 2013/14 to enhance wages of lower cadres of health workers along with further non-financial motivation for medical officers in HCIVs.
- Ministry of Education and Sports should closely work with Ministry of Health and partners to draw a training strategy of cadres who are in short supply in addition to scaling up the six month midwifery course for comprehensive nurses in post as one of the remedies
- Ministry of Health should accelerate the consideration of a policy to recentralize recruitment and deployment of doctors
- Ministry of health should provide a budget to induct newly recruited health workers
- Ministry of Health, Parliament, CSOs, media and other stakeholders should ensure that the promise by the Executive/ Ministry of Finance to provide a supplementary budget of Ushs43 billion is not broken, despite financial problems triggered as a result of theft of public funds and subsequent suspension of funding by some development partners
- Ministry of Health in collaboration with Ministry of Public Service and Ministry of Finance should ensure that any arrears owed to Health Centre IV doctors who were in post by 1st October 2012 are posted on their accounts and all newly hired staff access on the payroll as soon as possible