Local Government (MoLG) There are also Public-Private Partnerships for health (PPPH) whereby government and the
private sector cooperate to deliver critically needed services i.e. in immunization and in HIV/AIDS control.
The public health care delivery system in Uganda is organized in tiers, from the Village Teams, (VHTs), Health Center II,
III and IV at parish, sub-county and county level (Health Sub-District) respectively to general hospitals at district level.
The national and regional referral hospitals are semi-autonomous but largely facilitated by the central government
while the lower health centers and district hospitals are managed by the local governments.
Health Financing
Total Health Expenditure per capita is US$ 43 of which Government per capita expenditure is US$13. Government
currently spends about 43$ per capita on health, which is about the same as its low income country peers. Donor
spending is however quite high at 34% of total health expenditure (National Health Accounts 2013) while out-of-pocket
spending on health is at about 43% (NHA 2013) of total health expenditure. In this regard the draft bill is ready for
submission to cabinet and parliament for legislation of the National Health Insurance Scheme to address this high out
of pocket spending and to improve equity. The bill provides for citizens of Uganda to belong to the National health
insurance scheme and it caters for the indigent and the informal sector.
Health Service Delivery:
1. Human Resource in the Health Sector
Significant progress has been made in recent years in increasing the production of health workers and in producing a
multi-purpose nursing cadre that is able to perform both nursing and midwifery tasks. In addition the availability of
data on the public sector health workforce has also improved. A comprehensive Human Resource in Health (HRH)
policy and strategy to address priority HRH constraints is in place, although its implementation needs to improve.
Another encouraging development is the recognition of the need for human resource management and leadership
training in health. However, the HRH shortage and the pro-urban distribution of health workers (doctors, pharmacists,
and other cadres) remain major obstacles to access to quality health care in remote and hard-to-reach areas. In
addition, the wage bill limits the ability of the public sector to fill its vacant positions and to absorb the increasing
numbers of health workers produced; it is thus a major bottleneck to the performance of the entire health system.
Government however, provided funds in the FY 2011/2012, Uganda shillings worthy 4.5 billion to the MOH to recruit up
to 100% health workers for HC IIs to IVs including Senior Medical Officers. A total of 10,000 staff was expected and
July 2013, over 60% of these have been recruited.
In a bid to attract and retain medical officers at health center IVs, an enhancement of their salary by 1.500,000 was
provided. The Ministry with support from the Belgium Technical Cooperation and Health Systems Strengthening has
provided over 200 scholarships for hard to reach districts at College and University level. This staffs are expected to
work in their respective districts.
National level staffing Situation 2012
NO Cost Centre
No. of Units
1
Mulago Hospital
1
2
Butabika Hospital
1
3
Regional Referral Hosp 13
4
General Hospitals
47
5
DHOs Offices
112
6
HC IV
166
7
HC III
962
8
HC II
1321
Total Norms
2,801
424
4,331
7,980
1,232
7,920
5,634
4,905
Filled
2,423
393
3,121
4,905
698
4,768
3,363
2,197
Vacant
378
33
1,210
3,075
523
3,152
2,271
2,708
% Filled
87%
93%
72%
61%
57%
60%
60%
45%
9