{UAH} Uganda's health sector is sick, but I have a secret remedy for its ills - Comment - www.theeastafrican.co.ke
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Uganda's health sector is sick, but I have a secret remedy for its ills - Comment
In Summary
Hospital visits are unscheduled and come unexpectedly, so people don't plan for them; so investing in a health facility is not as reliable as building a school.
Buganda Kingdom Prime Minister Charles Peter Mayiga, who has just completed his first year in office, has distinguished himself as an effective fundraiser, collecting several billion shillings for reconstructing the royal tombs that were gutted by fire a few years ago.
He asked kingdom subjects to each contribute etofaali (a brick) towards the effort, and has already collected more money than required for the tombs but is not about to stop and intends to fund other kingdom projects as well.
Mayiga has thus demonstrated that there is money held by the population that can be mobilised to do good.
Uganda collects a smaller percentage of GDP as tax than comparable African economies though Ugandans are willing to part with money for a cause they believe in. Yet with its low tax collection record, the government about a decade ago gave Ugandans a pleasant surprise when it abolished the century-old local graduated tax, claiming it was expensive and degrading to collect.
May the same logic be applied to the rest of our taxes one of these days since they also cost money to collect and humiliate hard-up traders.
Now that etofaali has shown peoples' willingness to contribute billions to what they like, it is about time to extend similar effort to funding specific social service projects in underfunded sectors. This is not a call to reinvent the wheel.
In the 1970s and 80s, Kenya expanded secondary school education through harambee, where communities fundraised to construct schools and pay teachers in their localities. The system was extended to expansion of hospital capacity by building Nyayo wards all over the country.
If there is one area where fundraising can help Uganda it is the black hole called the health sector.
Treasury puts in a trillion shillings ($250million) a financial year to which the US adds $400 million, a figure US officials have quoted angrily several times in the past two years, yet the health sector remains sick.
In education, private schools are well established to supplement public ones, because they follow a regulated curriculum that ends in specific public exams, and a child's going to school is predicted and is planned for by the parent.
But hospital visits are unscheduled and come unexpectedly, so people don't plan for them; so investing in a health facility is not as reliable as building a school.
Furthermore, there is no enforceable "curriculum" for health facilities and most clinics are illegal, with some being run by quacks.
The billions of shillings that were freed up when graduated tax was abolished could be collected to build decent, well-equipped hospitals with well-paid staff in each of the country's 112 districts.
If everybody paid the minimal former GT contribution of Ush10,000 ($4) per year for health, then the southern district of Kabale with half a million people would have two million dollars for its (strictly) referral hospital every year. The northern district of Abim, with fifty thousand people, would have $200,000 for its smaller population.
But whom will the people trust to collect and use this money? Maybe local religious leaders who wouldn't be suspected of building a political power base. But they should account for it, unlike the offertory that the flock do not ask about.
http://www.theeastafrican.co.ke/OpEd/comment/Uganda-s-health-sector-is-sick--but-I-have-a-secret-remedy/-/434750/2340082/-/tkeb55z/-/index.html
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