Legislators have urged government to recruit more health workers to ensure newly upgraded and constructed health facilities across the country become fully operational.
The call followed a statement by Health Minister Chris Baryomunsi on the status and impact of the Uganda Intergovernmental Fiscal Transfers (UgIFT) health infrastructure programme and the proposed framework for UgIFT 2.
Presenting the statement to Parliament on Wednesday, Baryomunsi said 373 Health Centre IIIs had been established under the programme through the upgrading of existing Health Centre IIs and construction of new facilities in sub-counties that previously had no health facility.
The programme, he said, had increased the proportion of sub-counties with access to a Health Centre III from 61 per cent to 78 per cent.
“This represents a major investment in bringing health services closer to the population and addressing historical geographical inequities in access to healthcare,” Baryomunsi said.
He said the World Bank had provided Shs453 billion for upgrading, constructing and equipping health facilities, while government had committed Shs270 billion for maintenance and repair of buildings and equipment.
Baryomunsi said government had also recruited 4,628 health workers during the programme period.
He said the staffing structure for Health Centre IVs would be expanded from the current provision of 49 health workers to 130, including five medical doctors.
“We shall also upgrade all Health Centre IVs to community hospitals,” he said.
The minister said the proposed UgIFT 2 programme would prioritise strengthening the health workforce, ensuring the availability of essential medicines and supplies, and making health infrastructure sustainable.
Under the programme, the ministry plans to expand, rehabilitate, re-equip and provide staff accommodation at 100 dilapidated Health Centre IIIs across the country.
It also plans to establish 50 new Health Centre IIIs and 50 Health Centre IVs in heavily populated, hard-to-reach sub-counties.
However, MPs raised concerns that staffing shortages could undermine the investment in health infrastructure.
Soroti District Woman MP Anna Adeke called for an audit by the Office of the Auditor General to establish the exact number of UgIFT facilities that are non-functional and identify what is required to operationalise them.
She also asked the Ministries of Finance and Public Service to consider revising the wage bill cap for local governments whenever UgIFT facilities are ready for operation.
“It is a contradiction to build state-of-the-art facilities while maintaining a restrictive recruitment cap on local governments. Many health centres that have been upgraded are currently managed by overstretched nursing assistants or single midwives doing 48-hour shifts,” Adeke said.
Kwania District Woman MP Kenny Auma said some Health Centre IIs upgraded to Health Centre IIIs remained non-operational because of a shortage of key health workers.
“Most of these health facilities have few nurses and there are no clinical officers. Government needs to recruit more nurses, midwives and clinical officers to work on the patients at those health centres,” Auma said.
Entebbe Municipality MP Steven Shyaka said Entebbe Referral Hospital had only 260 staff against an approved requirement of 1,195.
He also raised concerns about inadequate medicine supplies and office space for doctors, saying the shortages were affecting service delivery and doctor-patient confidentiality.
“Entebbe is an international gateway for our country but when you look at the health facilities, there are few nurses to work on patients. There is no office space for doctors which affects the doctor-patient confidentiality,” Shyaka said.
Kalungu County West MP Joseph Ssewungu urged the Health Ministry to support missionary and religious-founded health facilities by deploying doctors and nurses and providing medical supplies.
He said such facilities complement government health centres, particularly in areas where public health facilities are overstretched.
Tochi County MP Peter Okot raised concerns about inadequate electricity in several sub-counties where UgIFT facilities had been established and asked government to address the challenge under UgIFT 2.
Baryomunsi told MPs that he would engage them during visits to their constituencies to undertake comprehensive assessments of health facilities and identify gaps that need to be addressed.
The proposed UgIFT 2 programme is expected to build on gains made under the first phase by combining infrastructure investment with staffing, medicines and maintenance to improve access to healthcare.
