Health care in Uganda is a major challenge. Uganda’s healthcare performance is ranked as one of the worst in the world, by the World Health Organisation in their World Health Report 2000. The country was ranked 149th out of 191 countries.

Recent statistics of the World Health Organisation1 show that life expectancy at birth in Uganda is 56 years. Child mortality (death before the age of five years) occurred in 141 of every 1000 births. At least one visit of antenatal care is accessed by 95% of the pregnant mothers, but only 48% of them access antenatal care at least 4 times (recommended). Also only 50% of pregnant women in Uganda with HIV receive antiretrovirals to prevent mother-to-child-transmission. The maternal mortality ratio for Uganda is 310 per 100,000 live births. As a comparison, the United Kingdom has a maternal mortality ratio of only 12 women per 100,000 live births. Lastly, with a population where only 35% uses improved sanitation, it is expected that preventable diseases will keep occurring.

A study was done in 2007 in 54 districts and 553 health facilities in Uganda to determine availability of emergency obstetric care and its related maternal deaths. The study found that few of these units had running water; electricity or a functional operating theater. However, having these items was shown to have a protective effect on maternal deaths.

The availability of midwives had the highest protective effect, reducing the case fatality rate by 80%. This study found that while 97.2% of health facilities were expected to have emergency obstetric care services, few had provided these services. This is the most likely explanation for the high health facility-based maternal death rate of 671 per 100,000 live births in Uganda in 2007. The study concluded that addressing health system issues, particularly among human resources, and increasing access to emergency obstetric care could reduce maternal mortality.

Despite this study and Uganda’s efforts to improve on its health care, the system still faces major challenges. In the Saturday Vision of 14 September 2013, the front page shows ‘Health centres in financial crisis’. The article explains that ‘the recent campaign to boost staffing in health facilities means several health centre IVs now have doctors, but a scarcity of operational fees and drugs threatens to overturn the achievement’.

All this shows the need for private health units to complement the government’s health facilities and ensure greater access to health care for the Ugandan population!