Health System

The health system in Uganda is based on a referral system, existing of different levels of health care. The healthcare provider in charge of the Health Center can refer the patient to a higher level and this can be continued until reaching the highest level. Hospital services are provided by the public, Private Not for Profit (PNFP), Private Health Practitioners (PHP), and Traditional and Complementary Medicine Practitioners (TCMPs).The private sector provides about 50% of reported services. Beginning in 2001 public health service in Uganda is provided without user fees; however, user fees in private wings of public hospitals remain. The public system is structured as follows:

Health Center I (HCI). Village level care. 2,500 throughout Uganda. HCI is the coordinating center for Village Health Teams (VHT). Government of Uganda (GoU) standards call for 1 VHT per 1,000 populations. The HCI has no physical structure but uses the VHT as a link between health facilities and the community. The VHTs are responsible for identifying the community's health needs and taking appropriate measures, mobilizing community resources and monitoring utilization of all resources for their health, mobilizing communities for health interventions such as immunization, malaria control, sanitation and promoting health seeking behavior, maintaining birth and death registration, and serving as the first link between the community and formal health providers. Community based management of common childhood illnesses including malaria, diarrhea, and pneumonia; as well as distribution of any health commodities availed from time to time.

Health Center II (HCII). Parish level care. 1,469 throughout Uganda. GoU standards seek to have a HCII or higher facility within 5 Km of any person. Standard level staffing for a HCII is 1 Enrolled Nurse, 1 Mid-wife, and 1 Nursing Assistant. The HCIIs provide the first level of interaction between the formal health sector and the communities. HCIIs only provide out patient care and community outreach services. An enrolled comprehensive nurse is key to the provision of comprehensive services and linkages with the VHT.

Health Center III (HCIII). Sub-county level care. 809 throughout Uganda. Standard level staffing for HCIII is 1 Senior Clinical Officer, 1 Clinical Officer, 2 Mid-wives, 1 Nursing Officer Nursing, 3 Enrolled Nurses, 1 Laboratory Technician, 1 Laboratory Assistant, 3 Nursing Assistants, and 1 Health Assistant. HCIIIs provide basic preventative, promotive and curative care and provides support supervision of the community and HCIIs under its jurisdiction. There are provisions for laboratory services for diagnosis, maternity care and first referral cover for the sub-county.

Health Center IV (HCIV). County level care. 154 throughout Uganda. Standard level staffing for HCIV is 1 Senior Medical Officer, 1 Medical Officer, 2 Senior Nursing Officers, 1 Nursing Officer Nursing, 4 Nursing Officer Mid-wives, 1 Nursing Officer Psychiatric, 3 Enrolled Nurses, 8 Enrolled Mid-wives, 5 Nursing Assistants, 1 Clinical Officer, 1 Clinical Officer-Eye, 4 Health Inspectors, 2 Laboratory Technicians, 1 Assistant VCO Officer, 2 Theatre Assistants, 2 Laboratory Assistants, and 2 Health Assistants.

District Hospital. District level care. 90 throughout Uganda. Standard level staffing for a district hospital is 2 Public Dental Officers, 4 Medical Officers, 2 Dispensers, 5 Senior Mid-wife Officers, 17 Nursing Officers-Nurse, 3 Nursing Officers - Mid-wifery, 2 Enrolled Psychiatrics, 46 Enrolled Nurses, 25 Enrolled Mid-wives, 15 Nursing Assistants, 5 Clinical Officers, 2 Radio-graphers, 2 Orthopedic Officers, 2 Anesthetic Officers, 2 Theatre Attendants, and 2 Laboratory Technicians. General hospitals provide preventive, promotive, curative maternity, in-patient health services, surgery, blood transfusion, laboratory and medical imaging services. They also provide in-service training, consultation and operational research in support of the community-based healthcare programs.

Regional Hospital. Regional level care. 12 throughout Uganda. Regional hospitals offer specialist clinical services such as psychiatry, Ear, Nose, and Throat (ENT), ophthalmology, higher level surgical and medical services, and clinical support services (laboratory, medical imaging, pathology). They are also involved in teaching and research. This is addition to services provided by district (general) hospitals.

National Hospital. National level care. 2 located in Kampala city. National hospitals provide comprehensive specialist services and are involved in health research and teaching in addition to providing services offered by general hospitals and regional hospitals.

Ministry of Health. The core functions of the MoH are policy analysis and dialogue, strategic planning, setting standards and quality assurance, resource mobilization, advising other ministries, departments and agencies on health related matters, capacity development and technical support supervision, provision of nationally coordinated services including health emergency preparedness and response and epidemic prevention and control, coordination of health research, and monitoring and evaluation of the overall health sector performance.

SOURCE: Government of Uganda Ministry of Health
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