15 Jun 2011


It's the economy, stupid!
"It's the economy, stupid" was a phrase in American politics widely used during Bill Clinton's successful 1992 presidential campaign against George H. W. Bush. At that time, Bush was considered unbeatable because of foreign policy developments such as the end of the Cold War and the Gulf War.
The Uganda health system is in a crisis; and, as a public health professional, I say, it is quality of care, stupid! This is because the stories emanating from the health facilities around the country point to only one thing: a gross failure in quality of care. 
Litany of tragedy
What is quality of care?
Quality of Care is “the degree to which healthcare services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Institute of Medicine, 2001). While the WHO considers Quality of Care as, the “proper performance (according to standards) of interventions that are known to be safe, that are affordable to the society in question, and that have the ability to produce an impact on mortality, morbidity, disability, and malnutrition” (Roemer and Aguilar, WHO, 1988).
Uganda’s MOH flunks the test of quality
From the indicators of quality of care above, the Uganda health system does not “increase the likelihood of (of achieving) desired health outcomes” for the vast majority of its users.
When one assesses the Uganda health system’s performance on the six dimension of quality: patient safety, effectiveness; patient centeredness; efficiency; timeliness; and equity; you find that it woefully fall short in all these dimensions.
Paying lip service
In many Ministry of Health documents, mention is made of quality of care; however, the quality of care has remained low in Uganda as evidenced by poor health indicators, especially maternal mortality and infant mortality. Yet, improving the quality of care can significantly contribute to the attainment of health-related Millennium Development Goals, especially the reductions in maternal and child mortality.

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