Committee On Health Meets With National and Regional Referral Hospitals
On the 22nd and 23rd of January 2019, the committee on Health met with the national and Regional referral hospitals to present their position on the national budget framework 2019/20. The meeting was chaired by Hon. Michael Bukenya the chairperson of the committee.
UNFUNDED PRIORITIES AND CHALLENGES FACED BY THE HOSPITALS
|· Medicines and sundries (86.64bn shortfall)
· Wage (50.344bn shortfall)
· Gratuity expenses (1.22bn shortfall)
· Utilities (2.0bn shortfall)
· Maintenance of infrastructure (1.1919bn shortfall)
· Hospital management system (3.00bn shortfall)
· Maintenance of equipment (1.5bn shortfall)
· Accommodation of Health workers
· Remodeling of upper Mulago (2.0bn shortfall)
|· Perennial Shortage of drugs and sundries
· The inadequacy of accommodation for health workers
· Land encroachment
|Butabika Hospital||· X-ray machine (800m)
· Hospital perimeter wall (5.0bn)
· MRI machine (3.5bn)
|· Inadequate human resource and difficulty in their attraction.
· Inadequate accommodation for human resource.
· High patient attendance and bed occupancy.
· High maintenance cost due to the high destruction rate by the patients.
· Lack of X-ray services.
· Land encroachment.
|Mbarara RRH||· Phase 2 of hospital expansion (30mUSD)
· Medical equipment workshop (400m)
· Upgrading of the oxygen plant (400m)
· Cancer Unit Construction (10m Euros)
· Land for expansion (700m)
· Solar power back up (200m)
|· Power outages due to yaka and high fuel consumption.
· Old buildings and limited space.
· Lack of equipment maintenance workshop, tools and staff.
· Poor staff attraction.
|Masaka RRH||· Purchase of ENT and orthopedics equipment (200m)
· Construction of medical stores (500m)
· Spares for equipment maintenance (120m)
· Construction of intern’s mess (500m)
· Construction of new administration block (1bn)
· Fencing of the hospital land (700m)
· Equipping the new MCH complex (2bn)
|· Medicinal shortages (medicine lasts 6 out of the 8 weeks)
· High power consumption (Ugx 413,411 daily)
· Land encroachment
· Heightened referrals in (Lwengo and Lyantonde)
|Naguru RH||· Specialist support supervision in the central region (0.146bn)
· New ambulance (0.3bn)
· Arrears for UTL, water, and electricity (0.338)
· Electricity back up system (0.0336bn)
· Oxygen plant maintenance (0.0565bn)
· Hospital expansion (19.847730bn)
|· Inadequate space for inpatient care, and staff accommodation.
· High costs of ambulance maintenance.
|Mubende RRH||· Reconstruction of the hospital fence.
· Completion of stalled construction of wards
· Construction of a blood bank
· Staff houses
· Staff transport
|· Lack of a fence
· Road construction causing dust and silting of drainage channels.
· Over delayed completion of construction of wards (5years)
· Stock-outs of medicines and sundries
· Blood scarcity
· Inadequate space in the JICA buildings
|FortPortal RRH||· Underfunding for NWR
· Inadequate accommodation
· Infrastructure including wards and offices.
|· Understaffing for specialists
· Underfunding of recurrent nonwage
· Inadequate accommodation
· Poor referral system
|Kabale RRH||· Ambulance for transporting referred patients (300m)
· Accommodation for staff (4bn)
· A dedicated power line to curb frequent cuts.
|· High utility consumption
· Low staffing levels
· Inadequate budget
|Jinja RRH||· Concrete wall fence (6bn)
· Emergency/casualty services (5bn)
· CT scan (2bn)
|· Need for staff structure review
· Recurrent failure to absorb the wage bill.
· The poorly defined relationship between the hospital and other district facilities.
· Old ambulance and the absence of an ambulance structure.
· Inadequate casualty services.
|Mbale RRH||· CT scan (1m USD)
· Mortuary (0.5bn)
· Administration block (1.5bn)
· Staff Accommodation (3.0bn)
|· High utility costs
· Staff accommodation
· Working space
· Old infrastructure
|Hoima RRH||· Old structures facelifts (0.2bn)
· IT equipment (CCTV, Vehicle trackers) (0.3bn)
· Medical Equipment purchase (0.7bn)
· Construction of intern’s mess & staff quarters (0.5bn)
· Patients food and nutrition support (0.2bn)
|· Unethical/ unprofessional staff behaviors.
· Understaffing for specialists and consultants.
· High Utility consumption.
· Insufficient staff accommodation
· Low functionality of lower level units.
· Frequent stock-outs of medicine and blood.
· Low funds for refugees and other activities.
|Soroti RRH||· An incinerator (300m)
· Maternal/ surgical complex (20bn)
· New medical and pediatrics wards
|· High electricity bills under yaka system.
· Lack of waste management facilities.
· Low staffing levels.
· Lack of workspace.
· Limited funds for capital development.
|Gulu RRH||· Construction of a perimeter wall (1.0bn)
· Procurement of a CT scan (2.5bn)
· Renovation of old buildings
|· Inadequate staffing
· High attrition of Health workers
· Lack of accommodation for staff
· Lack of funding for community services.
· Hospital premises still occupied by the School of Clinical Med.
· Hospital land still occupied by UPDF.
|Lira RRH||· Reconstruction of the Therapeutic Feeding Center (condemned) (500m)
· Construction of the private wing (2bn)
· Construction of staff houses
· Training and research (0.050bn)
· Arrears of rent to the municipality (0.200bn)
|· High staff turnover
· Dilapidated buildings requiring high capital inputs.
· Unsecured hospital premises.
· Heavy workload.
|Arua RRH||· Transformer (0.300bn 2020/21)
· Completion of the hospital staff house (2.900bn)
· Fencing of hospital land (0.500bn)
· Utility arrears (0.086bn)
· Construction of laundry (0.200bn 2020/21)
· Construction of the administrative block 1.400bn 2020/2021.
· Water harvesting systems (0.150bn)
|· Staff accommodation
· Understaffing of critical staff
· Reduction of the nonwage recurrent budget by 100m.
|· Moroto RRH||· Construction of new wards and administration block. (14.00)
· Construction of phase 3 of the staff accommodation. (2.400bn)
· Mortuary (0.500 bn)
· Construction of the intern’s mess (2.500bn)
· Installation of a backup solar system (0.200bn)
|· Failure to attract and retain critical cadres like specialists
· Old, inadequate and dilapidated infrastructure
· High fuel consumption for transportation of dead bodies to their burial grounds.
· Rampant outage of power, fuel, and generator repair expenses.
· The high cost of utilities.
COMMITTEE OBSERVATIONS, REACTIONS, AND RECOMMENDATIONS
- The committee observed a dilemma of dotted construction amongst the referral hospitals. They thus urged the Ministry of Health (MoH) to adopt a system of constructing a staff house for one hospital annually with a uniform structure of construction to curb this plight.
- The committee recommended equipping of district hospitals by MoH to minimize on the referrals to the RRH.
- The committee observed non-existence of an active board in some hospitals like Arua RRH for more than a year and thus recommended appointment of board members.
- The committee challenged hospital directors and other officials to lay suggestions on curbing the predicament of staff attraction and retainment especially specialists and consultants.
- The committee recommended Arua Hospital to rely on the Rural Electrification Agency for the restoration of the hospital transformer.
- The committee recommended to MoH to transfer all hospitals to three-phase electricity and drop the yaka electrification system.
- The committee resolved to visit some hospitals like Mulago hospital to acquire adequate information on land encroachment and staffing structure.
- The committee asked Mubende RRH to organize and send to the committee clerk copies of UNRA assessment for the compensation of the demolished hospital perimeter wall.
- The committee mentioned unethical/ unprofessional behavior as a common vice in almost all hospitals most especially in Naguru RH.
- The committee requested MoH to respond to the predicament of undersupply of diagnostic equipment. Hon. Jane Ruth Aceng elucidated to the committee of a drive project through which the Ministry in collaboration with the Netherlands is to receive a 50% loan and 50% grant for procurement of diagnostic equipment such as CT scans, MRI scans, and x-rays.