Medical Services Outreach Project in Uganda

In Uganda, the access to specialized surgical and clinical care is still low particularly in the rural areas. While most of the issues focus on the lack of workforce, it is critical to recognize the infrastructure gaps that hinder the ability of the health system to provide accessible and affordable surgical services. Many of the hospitals in Uganda do not meet the minimum standards that the WHO deems essential for the provision of surgical care. Provision of surgical care for conditions such as hernia and caesarean sections are supposed to start at level IV of health services delivery; however, the progress towards fictionalization of surgical care at this level remains poor. The functionality of HC IV increased from 23% in 2009/10 to 24% in 2010/11 and achieved 25% in 2011/12. Renovation, equipping and provision of alternate sources of power were undertaken in a number of HC IVs in the country however, a number are still non functional mainly due to lack of qualified staff. The MoH annual health sector performance report (AHSPR 2011/12) indicates that only 38% and 24% of the health centre IV levels were able to offer major surgeries and blood transfusion services respectively. Staffing at all levels of the health care delivery remains a big challenge with averagely 58% of available positions filled. This however varies greatly with some rural districts in hard to reach areas posting staffing capacity of less than 35% while in urban settings; hospitals are staffed up to more than 80%.