Uganda health sector problem bigger than chemistry passes

BY ALEX TAREMWA

In December 2014, my nephew Sheldon was admitted at Holy Innocents’ Hospital, one of the best children hospitals in Mbarara. He was anemic, dehydrated, and he had malaria that forced him to stare death in the eye.

When I arrived, I was ushered into the ward by a nurse who I later learnt was a Uganda Christian University (UCU) Nursing Science student doing her internship.

As an alumnus, I left that day feeling safe; I knew my title of uncle would last a lot longer. When I returned in the morning, I found the nurse babysitting and feeding the baby. Her conduct, discipline, competence and knowledge portrayed nothing short of professionalism.

It is possible that this young lady did not do or pass chemistry at A-level and even armed with her four-year hard-earned degree, the Uganda Nursing and Midwives Council (UNMC) will not register her for practice.

In principle that is the right thing to do, but does it solve Uganda’s health sector problem?

The Ugandan health sector has experienced challenges related to recruitment and retention of qualified staff, mainly due to low remuneration as well as insufficient career opportunities.

According to the Budget Monitoring and Accountability Unit (BMAU) in the Ministry of Health report, in 2010 there was a very low doctor to patient ratio of 1:24,725 and a nurse to patient ratio of 1:11,000, way below the World Health Organisation (WHO) recommendation of 1:439 as the health worker to population ratio.

Worse still, maternal and infant mortality are still going through the roof, traditional midwives are still delivering babies with their rudimentary tools, clinics and pharmacies across the country are manned by nurses with three months’ training or even less – some reusing syringes for injections and getting away with it.

For Uganda to meet the minimum health standards, the number of health workers must triple. Attention, therefore, needs to shift from cheap politicking to the core of the problem, which is poor composition of health professionals.

According to the 2011 Human Resources for Health Audit Report, with respect to the national level staffing, the proportion of the filled approved positions was found to be only 58 per cent.

Out of the 55,063 approved positions, only 31,797 are filled, leaving 23,321 vacant positions. The situation is worse at the level of health centre IIs. Out of 4,905 posts in 1,321 health centre IIs in the country, only 2,197 (45 per cent) are filled.

I admit that there could be life threatening consequences arising from a health worker’s lack of chemistry knowledge or background, but I submit there are greater consequences from having none at all.

Enough of the games, if UNMC lacks the guts to do the right thing; that is waive chemistry only for the degree holding nurses without it so far, for the sake of Ugandans, someone else should.

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