PPP for universal health service not translated into increased access for the poor in Uganda – Study
Kampala, Uganda (PANA) – The government of Uganda has settled on Public-Private Partnerships (PPPs) as the vehicle to achieve universal access to health services for its 40 million people.
However, a new study shows that reliance on PPPs has so far not translated into increased access to health services or equitable treatment for poor Ugandans.
Initiative for Social and Economic Rights (ISER), a non-governmental organisation, carried out the study to ascertain whether health, finance and development policies are translating into the provision of services in a way that guarantees the rights of Uganda’s vulnerable populations.
The findings are embodied in a report entitled, “Achieving Equity in Health: Are Public Private Partnerships the Solution?”
The report says: “There is no evidence that strengthening the private sector results in better health outcomes for the poor and rural communities. If anything, evidence has shown that private for profit is unlikely to deliver better health outcomes for the poor people and exacerbates inequalities, resulting in the rich able to access better healthcare and the poor excluded.”
It adds: “This research has revealed that the use of PPPs can result in a growing discriminatory gap between the haves and have-nots and debunked unsubstantiated assumptions that the private sector is more efficient, cost effective and its involvement will have a positive correlative effect on health outcomes.”
The report notes that the government has over the past decade or so spent between seven and nine percent of the budget on health service provision, way below the 15 percent that African Union Countries committed to in the Abuja Declaration.
It urges increased expenditure on the sector because, it argues, the poor are the ones most likely to use free medical services, making investment in health an important way to redistribute income.
The report notes that the government has not lived true to its commitment to provide healthcare to the poor, especially those in geographically isolated.
“Instead, it (government) relies on mostly foreign donor and religious PNFPs (private-not-for-profit) to provide essential services. Sometimes, the government provides significant funding to PNFPs to service an area in lieu of establishing public facilities,” the report notes says.
Uganda has registered improvements in some areas of health service provision, with positive developments in some indicators while others remain a challenge.
For instance, under-five mortality rate declined from 109 to 53 deaths per 1,000 live births between 2006 and 2016, a development which the government is proud about, but maternal deaths remain at 336 deaths per 100,000 live births, still among the highest in the world.
-0- PANA EM/MA 18May2019
