Communities generate evidence to inform national advocacy for improved human resources for health in Uganda

Article type
Authors
Asinguza AP1
1PATH
Abstract
Background: Advocacy for Better Health aims to equip citizens with an enabling environment and systems to effectively advocate for strong action plans to improve health services. This is because the 2020 Government target is for Uganda to transform into a middle-income country (National Development Plan II, 2015) will be achieved if investment is made in keeping the population healthy and productive.

Methods: Citizen participation as an important foundation for change (Parker, B, 2003) has been emphasised to gather data through participatory rural appraisal (Chambers, R., 1997) and inform evidence-based advocacy for recruitment and motivation human resources. Citizens conduct problem ranking during advocacy forums on staffing levels and health worker absenteeism. Citizens prioritised inadequate number of midwives and absenteeism. On triangulation, the health worker to population ratio in Uganda remains at 0.25/1000 which is far below the World Health Organization (WHO) threshold of 2.3/1000 (IntraHealth, 2015).

Interventions: Working with IntraHealth, the project advocated for recruitment of critical skilled staff (doctors and midwives) and scale up health workers' motivation strategy to reduce Uganda’s Neonatal Mortality Rate of 22/1000 and Maternal Mortality Ratio of 320/100 000 (World Health Series, 2015).

Results: Government has committed to increase staffing to 80% by 2018 (Health Sector Development Plan, 2015), 10 districts have passed ordinances and revived use of duty rosters to address health worker absenteeism. The better health advocacy debate has been elevated with need to increase health-sector budget allocations from 8% to 10%.

Conclusions: Building a body of evidence from citizens enhances the advocacy agenda. Communities will further monitor government commitments to reduce the Neonatal Mortality Rate and Maternal Mortality Ratio.