Health Minister Reassures Medical Workers of Improved Welfare

 Minister of Health-General Duties Hon Dr Chris Baryomunsi (on podium) addressing members of White Ribbon Alliance  Uganda during the Annual General Members' Meeting at Statistics House, Kampala

By Njaleruma Kigozi,

Citizen Journalist, 

The White Ribbon Alliance Uganda

Buikwe District

State Minister for Health General Duties, Dr. Chris Baryomunsi reaffirmed the Uganda Government’s commitment to improve the welfare of medical workers in the country.

Baryomunsi was addressing members of White Ribbon Alliance Uganda (WRA- Ug)—a non government organization, advocating for safe motherhood and a nation free of newborns deaths, at its Annual General Meeting (AGM) at Statistics House in Kampala on Friday 27^th March, 2015.

Baryomunsi, who was the Guest of Honour at the event, said that an increase in negligence of duty and carelessness by medical workers in government health centers and hospitals across the country has been identified as a major cause of loss of lives, mostly of pregnant mothers and newborns during pregnancy and birth.

He said that such a situation has been blamed on the usual complaints that medical workers in the country get little pay and a raw deal from the central government that employs them, compared to their counterparts in other countries where their services are equally needed. “They can only be held responsible in terms of service delivery to the pregnant mothers and other citizens in the country only when the people who handle life at our health centers enjoy a better pay and a competitive welfare” he added.

Knowing very well that childbirth is still a death trap in Uganda, claiming the lives of 17 women and 106 newborns every day, the Minister said that the problem can only be partly tackled by improving the welfare of government workers, including medical workers, and that they are prepared to fulfill this obligation.

Baryomunsi also revealed that his ministry was in preparation to send senior officials to health centers around the country to reassure medical workers that the central government has big plans in store for them, particularly in improving their working conditions. This is aimed at changing their attitude towards work.

The White Ribbon Alliance Board of Directors Chairperson Mr. Obed Kabanda told the gathering that WRA-Ug has dedicated a dynamic advocacy campaign, “Act Now to Save Mothers,” to hold the government accountable to its commitment to ensure that women have access to life-saving care.

He emphasized the need for the central government to provide Emergency Obstetric and Newborn Care (EmONC).  “Take this as a priority intervention to reduce maternal and newborns deaths in Uganda,” Kabanda said.

Lira District Woman Member of Parliament, Hon. Joy Atim Ongom, who also attended the AGM, strongly attacked men in her area of jurisdiction who spend money and time in bars drinking alcohol, whilst women they make pregnant are languishing with the pregnancies in their households with little or no financial help and care. She called them irresponsible husbands.

L-R: Lira District Woman MP-Hon Joy Atim Ongom, Hon Dr Chris Baryomunsi-Minister of Health (General Duties) and Mr. Obed Kabanda-Chairperson BoD White Ribbon Alliance Uganda

“Some men in Lira, like in any other district in Uganda, not only neglect their pregnant wives during pregnancy and at the time of delivery but go on to mount them forcefully at night for sex even when they are not in the mood,” Hon. Atim said and added that such occurrences add salt to the already dangerous wound/ situations pregnant mothers are going through. She called on men to be responsible and take lead in saving the lives of women they impregnate.

Ms Robinah Biteyi, the National Coordinator WRA-Ug reminded the gathering that women and newborns die from preventable and treatable complications that include, severe breeding (heamorrhage), infection (sepsis), eclampsia (high blood pressure), obstructed labor, unsafe abortions and asphyxias. She added that the causes are worsened by lack of or inadequate emergency obstetric and newborns care equipment/device, medicine and health supplies, skilled staff, especially with midwifery skills and resources necessary to provide quality life saving care in order to reduce maternal and newborn mortality.

“Those are the things the government can provide in time without being hoaxed or pressurized if our mothers and newborns can see light even for another day,” Biteyi said.

She suggested that the government should ensure that there are more health centre IIIs and IVs providing Emergency Obstetric and Newborn Care (EmONC) and more health center IIIs and IVs with adequate medicine, health supplies, equipment and skilled staff to provide EmONC services. She added that community members should demand EMONC at HC IIIs and IVs, more women should be delivering at health centers and that there should strong linkages between the formal health system and the community. Biteyi said the government should involve citizens in setting their health priorities.

In her closing remarks, the Woman Member of Parliament for Kabale District Hon. Rhona Ninsiima reminded the people of Uganda to hold the government accountable to its commitment to ensure that women have access to life saving care. She called on citizens to always sign petitions asking on their members of Parliament, district and sub county leaders to allocate sufficient funds to provide medicines, health supplies, equipment and skilled staff to save the lives of pregnant women and newborns at their local health centers.

The participants at the AGM asked the government to provide a motivation package for health workers and to functionalize operating theatres by allocating sufficient funds to renovate and equip them.

Email: communityhealthinitiativeprogram@yahoo.com

Shs225 million needed for resuscitation machines

A set of the device contains an ambu bag (neonatal bag) and mask used to blow air into the lungs; suction bulb for sucking out the mucus and a training mannequin to be used to train health workers on the procedure

By Sandra Janet Birungi

Posted  Thursday, March 26  2015 at  02:00

Kampala. A total of Shs225m is needed to buy resuscitation devices used to suck out mucus from lungs in newborn babies to enable them breathe and survive thereafter.

The failure to breathe at birth, known as birth asphyxia, is one of the leading causes of child mortality and can be prevented by use of resuscitation devices. The device costs about Shs300,000, according to Mr Moses Kamabare, the executive director of National Medical Stores (NMS).
“If we are to go by the 2013 study conducted by White Ribbon Alliance in the districts of Lira, Mityana and Kabale, on average, 20 machines are needed per district. With 112 districts, we would need 750 machines; and with each machine costing about Shs300,000, we would need Shs225m to buy them, which is not expensive,” he said.

Dr Jesca Nsungwa Sabiiti says one in every 10 children born needs resuscitation at birth, accounting for 106 deaths every year or 26 per cent of the neonatal deaths in the country. She adds that if these deaths are not addressed, child mortality will not be reduced.
“Most deaths in children are preventable and one of the ways of preventing them is through the use of these devices; they should be distributed to health centres together with the drugs from NMS. But for them to be made available, districts have to request for them such that the ministry can undertake the exercise to purchase and distribute them countrywide, he said adding: “It is also important to purchase the right devices which can easily be used at the health centers.” 

To ensure that health centre IIIs and IVs across the country get these devices, Dr Anthony Mbonye, the commissioner for community health services at the Ministry of Health issued a directive to NMS to include the purchase of the devices.

Ms Robina Riteyi, the national coordinator of White Ribbon Alliance, said this will be a more sustainable form of ensuring they are available for use at the different health centres.

jbirungi@ug.nationmedia.com

Source: http://www.monitor.co.ug/News/National/-million--needed-resuscitation-machines/-/688334/2665536/-/uihcsoz/-/index.html

The General Manager National Medical Stores Moses Kamabare chats with Commission Clinical Services Dr Jacinto Amandua after the policy feedback meeting at Mackinnon Suites

L-R: WRA-Ug National Coordinator Robina Biteyi, AMREF Project Coordinator on UN Life Saving Commodities Dr. Stephen Ayella and Asst Commissioner MoH Dr Jesca Nsungwa during a policy feedback meeting organized by White Ribbon Alliance at Mackinnon Suites

White Ribbon Alliance Senfuka Samuel consulting National Medical Stores Board Member Ms Sarah Nyombi (R) and The General Manager Mr Moses Kamabare at the meeting 

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

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. 

READ: Plan to export medical staff to Trinidad lands Uganda govt in court

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.” 

SOURCE: The East African- http://www.theeastafrican.co.ke/news/Graft-claims-hit-Uganda-medic-export-scheme/-/2558/2615980/-/x8utqbz/-/index.html

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

Civil Society Demands Government of Uganda Halt Plan to Export Life Saving Health Workers