The Challenge
Uganda has made significant progress in reducing the percentage of population living below the poverty line, promoting gender equality, empowering women, increasing access to safe and clean water and creating avenues for information and communication technology. However, significant challenges remain, and government spending on health remains low, at just seven percent of the national budget, equivalent to US$14 per capita, according to the Uganda National Health Financing Strategy 2016.
The GFF Partnership Response
The GFF partnership supports the government of Uganda to identify priorities in the health sector, advocate for increased investment, achieve effective use of existing funds, and target resources to achieve greater coverage of high-impact interventions. With GFF support, Uganda revised its Sharpened Plan to serve as its Investment Case focusing on delivery strategies to improve outcomes and prioritize the scale up of key interventions. In addition, the government is implementing a roadmap to address key reforms, particularly through results-based financing and voucher schemes to improve efficiency in resource utilization and quality of health service delivery. The reforms are being implemented in both the public and private sectors. Partners that contribute to financing are Global Fund, AMREF, Clinton Health Access Initiative, Gavi, Islamic Development Bank, JSI, Living Goods, Marie Stopes Uganda, PSI, Save the Children Uganda, UPMB, UNFPA, UNICEF, UNOPS, WHO, World Vision Uganda, and the governments of Belgium (BTC), Korea (KOICA), Spain, Sweden (SIDA), United Kingdom (DFID), and United States (USAID).
The Result
With reforms being implemented, the result has been a reduction in fee-barriers and improved access to high-priority maternal and child health care interventions especially for the poor. The government’s strategic purchasing of the package of essential health services is expanding. In the first half of 2019, 341 health facilities in 28 districts were participating, with another 395 health centers in 51 districts having completed the prequalification assessments and training needed for implementation. As of July 1, 2019, 79 districts were implementing the program at scale. Initial results suggest that priority interventions in their investment case, Sharpened Plan, such as health worker mentorship, vouchers, and the results-based financing approach, are all creating conditions for improved coverage of services where they are being delivered—notably in the Northern Region—a positive sign as these approaches are expanded to places like the Central Region.
More information on how Uganda achieved results are available at the latest GFF Annual Report.