The Ugandan Rural health care is dissatisfying to both the patients and the health workers. This is because the patient comes in need of a service and rarely gets it in its recommended full package. Most health care centers have health workers who are skilled but lack equipment to give that service which leads to unnecessary referrals and sometimes uncalled for deaths.

For example; I received a mother who came with a baby that had severe pneumonia. I couldn't give them the service because they were no medications available. Therefore, I had to refer this poor mother who went crying because she couldn't afford transport to another bigger hospital.

I am not so sure whether that innocent child survived.

Another example is failure of a midwife to control PPH after delivering a mother due to lack of medicines to do so.  Just imagine delivering a mother under candlelight or small torchlight. So many medical errors do occur due to system problems and lead to unnecessary deaths. In a nutshell, therefore, health care workers are demotivated whereas patients are equally dissatisfied.

Other Challenges that we face are; poor infrastructure most especially in hard to rich areas, lack of enough space in most rural health centers, health workers being abused by dissatisfied patients, rude colleagues (health workers) due to work overload and burn out, poor staff remuneration in terms of salary and allowances which leads to high staff turnover.

parting remarks/ advice to stakeholders;

  • Healthcare for all can never be achieved with health worker dissatisfaction. Something must be done about staff remuneration and infrastructure.
  • There is need to provide the incentives and equipment that the health worker needs to provide any health care required by the patient. Improvement on health care setting infrastructure is essential.
  • A bottom-up approach is required for policy making by the MOH because implementers understand the system better which is why it's necessary to involve them in policymaking.
  • Need for intensified supervision which is a problem and therefore solution finding. This will reduce the laxity by health workers in these rural health centers.
  • The permanent and pensionable policy should be replaced by contract system which will make health workers more responsible at their workplace with fear of their jobs in case they messed up.
  • In-service training of healthcare workers to improve their skills since medicine is always dynamic.


This email address is being protected from spambots. You need JavaScript enabled to view it.Senior clinical officer, Uganda