Re-assuring our commitment to patientsWhat a year of success amidst one of the weakest financial years in RHU history. Our commitment remains to patients and our focus is to ensure they get the best of care, at the nearest healthcare facility without fail but that comes with a tremendous price. Challenges in Uganda’s Healthcare system are not new but accessibility challenges continue growing.
Without Public Health Insurance, and the increasing poverty in general, private Healthcare insurance is under 0.5% GDP. 71.73% of Ugandans require a full hour of walking on foot to get to the nearest health facility1. Essential Medicines and clinical tests remain generally unavailable and unaffordable in Uganda2.
We still only approve 6% of the total quarterly requests for medicines and supplies and this only happens when our major donor, The Third Doctors provides some financial support. With a lot of luck, we received financial support for this particular quarter and have completely disbursed resources.
Majority of the Health facilities cannot transport their own medicines as donated by RHU. After COVID-19 lock-downs, network facilities closer to RHU offices where asked to pick up their batches of supplies donations but many pick them late or continue to request a delivery citing unavailability of transport.
Available statistics show that more than 80% of our population cannot afford healthcare costs and yet in only the last three years, the country has experienced several epidemics including; COVID-19, Ebola, Marburg, polio, Malaria, Rift Valley fever, yellow fever and Crimean Congo haemorrhagic fever outbreaks.
Clearly, with the current situation in the country, Healthcare is not on any government priority list and it is upon us as healthcare workers to find common ground that will shape the future of healthcare services in this country. It is those actions of the current leadership that have pushed the healthcare systems to the edge and for RHU to plan ahead for a crisis bigger than is right now.
Nonetheless, we will not feel sorry for ourselves, we must continue working hard, together, to ensure that services remain available in the least, BUT available.
Our hope remains in physical and financial support from other entities, as we support government health departments to understand the need for a healthy country and therefore we must stick together, work together and find solutions together to protect communities from further pandemics and infections through education, treatment and community mobilisation.
RHU continues its commitment to healthcare providers, we will support, and train where we can and continue lobying for resources from partners to ensure that you continue to support your communities.
Thank you. Eliezah Titus Busonga (Dr.) Executive Director.
We anticipated a crisis in the clinical sector based on the trends in accessibility and financial constraints in Uganda. We have seen a series of clinical strikes that continue to-date. Many of the Public Senior Health Officers in Uganda cannot be paid. Hospitals have no consultants working on patients while rural facilities have been abandoned by healthcare workers in search of survival at private health facilities or abroad.
We anticipated crisis because crisis has existed since time memorial but even more crisis after the COVID-19 Pandemic. One Pandemic after another, the rising cases of Polio outbreaks, The Ebola Outbreak among other Public health challenges has not left the healthcare sector in Uganda the same.
We are struggling to keep guard to vulnerable communities and our efforts cannot be limited.
We do not expect things to get any better any time soon. Our government is struggling with challenges caused by corruption among so many other issues. Therefore, we must prepare ourselves to brace the wave from crisis to crisis until we see the light at the end of a tunnel. This Quarter continues to address such and even more challenges both physically and online through engagements that are promoting community health, keeping medicines in hospitals and growing an hungry spirit to serve amongst Healthcare Human resource we are engaging with. We wil continue engaging TTD and other local partners to support these efforts.
Fourteen (14) of Three hundred Eleven (311) Medicines & Supplies requests have been supported for this quarter, the number of requests had steadily grown since 2015. Public Facilities take lead in requesting for additional medical supplies while private facilities request for complex resources that may be expensive for specific patients.
Theres a high Malaria Prevelance in Uganda at the Moment and our focus was to make sure that we approve all the Malaria Treatment requested for by facilities and given to those chosen to receive support in this quarter. In fact, hospitals from high-risk areas stood a better chance for this batch.
We donated some traditional Clinical beds to Bududa C Health Center IV and these were the only beds donated in this batch, not the best of Beds but due to circumstances, these would run the facility for a few months if not years. Unfortunately, the facility requires three extra beds for Maternity and these are extremely costly for us. We are mitigating fundraising but we cannot know for sure if this will work.
A few scholarstic materials were sent to two different orphanages supported by TTD. We could only manage to support four (4) Kids with scholarstic materials. We have requests for Clinical Kits for Orphanages but we do not have the resources to purchase these. Orphanages are reporting quite a number of Mental Health cases and the requirement for first aid including trainings.
There has been reduction in performance of some of our old network facilities causing them to initiate the Employee Assistance Protocols that require Municipal Councils to receive support on their behalf.
Municipal Councils are responsible for monitoring how these facilities use the support RHU Provides and are bound to report on it in their Municipal Reports to Local Government. This saves RHU the time to Report to the Central Government on how support is provided.
We gave Clinical thermomenters, two Autoclaves, medicines and some surgical gloves to two municipal councils on behalf of Mulangwe HCIII and Nansana HCII respectively. We have received response from both facilities that they are receiving resources from that batch as required and that past and future reports are under way and will be shared in due course.
We are assessing the increasing cases of hypertension and Mental Illness. We already believe that the increasing challenges associated with the economy in Uganda and around the world is playing a big role in the Mental and physical wellbeing of our people.
Although we have a project on Mental Health, it is not equitably active to handle Mental Health in our communities due to lack of enough resources. We are applying for the necessary funds but are yet to receive response to that effect.
Based on statistical data from government and reports from our network facilities, Malaria symptoms are now killing very many young children under 5 years of age and one of the leading cause of Neonatal Deaths in Uganda.
Evidence shows that Malaria Deaths are high in the months of May, June, July and November Each year. This Puts our next quarter, April-June at the critical highest level that requires purchase of Paediatric Doses as have been requested for by facilities. This will continue the trend of provision of Malaria Doses more than any other requested medicines if resources allow.
Our Staff worked with the Mama Mary Dominiciary from the 23rd to 27th, January 2023 to treat Malaria In Children under 5 and due to lack of financial resources, only 5 patients could see a specialist every day for that period of time.
We want to hold the Uganda Korea Medical Camp this year. The last on-site Camp was in 2015. We are holding conversations with local entities to see if we can rally support towards the camp.
Five (5) Health centers are willing to host the camp free however, facilitations on medicines and supplies, human resources and accomodations/ meals remain a burden we cant find our way around.
For the quarter October to December 2022, treatment accessibility at all our supported facilities remained at 36%. Patients reffered to specialists on the RHU PUHMED list were 69. This number increases every time we receive support from TTD and we do not expect anything different this quarter. We are out of financial resources but some of the activities especially those focusing on paediatrics treatment continuing on good faith between the facilities and RHU as we search for funds.
There are very many loopholes in our education system that are affecting the quality of care, the delivery of care, directly affecting Access to such care.
Together with Ministry Of Health, we run an update session on Zoom Every Thursday to review performance on Maternal and child health. The commissioner in Charge of Reproductive Health at MOH Chairs these sessions and a weekly update is provided.
We continue building capacity through our hubs and networks to ensure that quality of care is met. Information on treatment and care, patient satisfaction and provision of free healthcare services continues to flow through public and internal channels to ensure all stakeholders are in the loop.
The need to strenthening community capacity on Water, Sanitation and Hygiene is paramount. We are also mitigating community engagement on Neglected Tropical Illnesses however we are short on resources to continue engagements.
We want to build our team, we grow by the day but orientation is important. Our teams are providing supportive care to patients at network facilities and are expected to go there with advanced medical skills that we can provide but we have not yet commited to as a means of increasing accessibility for our beneficiaries. Government continues to ask us to do this even for public health support staff.
We have facilitated three (3) online capacity building sessions for paediatric nurses and are expecting a physical engagement with General Practitioners from Nsambya Hospital in March.
We want to increase access to information on Mental Health but we do not have it. We want to learn from developed countries about how they handle cases and channel that knowledge into our systems to better support mental health patients at network facilities or in communities.
We have developed the Natal Concept manual to support pregnant women but due to lack of resources we have not moved it around enough. Suggestions are to distribute it every quarter through the supplies deliveries but we cannot be sure it will be shared. We need to find financial support for healthcare information to ably support community education as a means to decrease community infections and or illnesses.
Based on the quarterly updates for October to December 2022, of the Nine (9) facilities that received support for that, RHU services engaged 6971 Patients but only 2765 Patients received free medical services.
Mental Health is not yet added to the assessment sheets but a few facilities reported handling such cases without any help. Our Community teams providing social services engaged 915 Patients, some of these benefited from the SOMI bus services while others were follow up patients.
More facilities received approval for assessments than those that received support. We did not have enough money to facilitate more supplies to facilities and majority of the facilities had not submitted last quarter’s reports. By Reporting time, we had receieved enough reports to determine impact for last quarter.
We want to make changes to the website to ensure that it reflects all the work as its is done. The current website lacks cordination and requires a bit of rechanneling to speak to our work. The templates to use by everyone who is reporting will be developed however an invoice for development has been issued to us at $825.
We have moved up to $6320 per quarter in expenses in medical supplies. We donot have that budget but it is needed. The Ministry of Health has urged that we participate in fundraising events but also that requires a budget. The March 17 Meeting is scheduled to discuss these engagements and see way forward.
We are working hard to ensure that we donot have to deal with noncompliancy to Clinical guidelines by ensuring that our assessment of health facilities remains valid. Quality Assessments are part of the requirements fulfilled in order to provide healthcare services for RHU. These are done every quarter to avoid clinical damages.
We need to invest in Quality Services education for our network members, the March 17 meeting will provide guidance on resource mobilisation for such trainings.
We now have weekly maternal and child health surveilance updates which are to be uploaded on the website, we need to incoporate the same system in other programs to ensure that information is shared.
Our Major donor has priorities and engagements in other countries. We need to find ways of ensuring them that their resources are what is holding our communities together. The Meeting of March 17 should inform conversations with The Third Doctors on how we can continuously receive their support for effective planning.
We need to raise a budget of at least $61202 a year for only programs. We should consult our partners and government on how to do this. We will then develop a fundraising strategy to follow.
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