MPs recommend UGX 173Bn to save health sector from COVID-19 distress

Kampala, Uganda |  THE INDEPENDENT |  The Health Committee of parliament has recommended for the allocation of Shillings 173billion towards mitigating the impact of COVID-19 on the health sector. The Committee chairperson, Dr. Michael Bukenya notes that the outbreak of COVID-19 exerted pressure on an already challenged system with problems in staffing, infrastructure and equipment.

He was presenting his committee report on the health sector Budget Framework paper for the 2021/2022 financial year to the Budget Committee of Parliament in a meeting chaired by the Vice-Chairperson and Kachumbali County MP, Patrick Isiagi on Thursday. He further notes that the pandemic disrupted essential health services such as immunization, maternal and child health care and HIV/AIDS/TB.

Dr. Bukenya says that the funds will mitigate the dangers posed by the pandemic in 2021/2022 financial year. He also noted that the failure to integrate COVID-19 in the routine health services has the potential of breaking down the health system, which is very difficult to resuscitate. It has been noted that supplies of PPE, or personal protective equipment, such as gloves, face masks, face shields, aprons and others are insufficient or are lacking in most hospitals. 

The committee’s recommendation also comes amidst news of the lack of functional ICU facilities at many regional referral hospitals. The capacity gap upcountry has meant the burden of treating critically-ill Covid-19 patients is piled on health facilities in Kampala including Mulago National Referral Hospital. 

An ICU comprises a bed, a patient monitor, a mechanical ventilator, a suction machine, critical care nurses, an anesthesiologist and physicians. ICU requires to be staffed round-the-clock with intensivists, anaesthesiologists, critical care nurses and physicians, according to Dr. Henry Mwebesa, the Director-General of Health Services. Dr. Bukenya also stresses that all funds donated towards fighting COVID-19 have to be appropriated by Parliament.   

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This was one of the 13 key outputs he noted is critical to the delivery of NDPIII interventions that in total have a funding gap of 355bn Shillings. The proposed budget for the sector for the 2021/2022 financial year amounts to Shillings 2.522.88 trillion, which translates into a decrease of 258.29bn Shillings from the current financial year. 

The other critical funding gaps noted by the committee include Shillings 21bn needed to improve the functionality of Kawempe, Kiruddu and Entebbe referral hospitals. Dr. Bukenya says only Shillings 14.12bn of the required Shillings 35.12bn has been provided and yet the funds are needed to improve the functionality of the health system to deliver quality and affordable preventive, promotive, curative and palliative health care services. 

The health committee has also recommended for the allocation of an additional Shillings 5.71bn towards the Uganda Blood Transfusion Services. Dr. Bukenya notes that only Shillings 7.08bn has been provided and yet the agency requires Shillings 12.79bn in order to increase access and availability of blood.

The committee stresses the need to establish an Emergency Medical Service and National Ambulance system, which has a funding gap of Shillings 26.88bn for the first phase of the programme. 

The committee notes that establishing the EMS will be done in a phased manner over a period of three years and will constitute 14 regional call and dispatch centers across the country, 350 ambulances, non-rotational staffing of emergency units at Medical Officer Special Grade, Medical Officer and emergency medical trainee, four call center staff per region, pre-hospital coordinators, professional ambulance staff and drivers. 

The Tororo South MP, Fredrick Angura raised concern on whether funds had been allocated for the upgrading of Malaba health center III to a health center IV. 

Angura’s concern was in relation to a revelation by Dr. Bukenya who noted that since 2018 government has embarked on the phased upgrade of Health Center IIs to HCIII and HCIIIs to HCIV.

The upgrade of the first batch of 124 health centers for the FY 2018/19 only 118 was completed, for the second batch of 64 for FY 2019/20 only 40 were completed. The third batch of 62 for FY 2020/21 construction has not started. The slow pace was attributed to among others delays in disbursement of funds and laxity by accounting officers and project managers to commence procurement processes and contract signing.

The health committee recommends that by the end of February 2021, the ministry of health should submit to parliament strategies to address delays in construction and fast-track completion of upgrades. The committee has also recommended for the allocation of an additional Shillings 23bn towards the rehabilitation of General Hospitals. 

The report notes that some of the hospitals were constructed a long time ago and are in dire need of renovations since their infrastructure has broken down. Of the required 36.13bn shillings only 13.13bn has been allocated. 

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