Bottlenecks to Primary health care in
Uganda
01/05/2025
Introduction
• Several factors impede primary healthcare access and delivery in
Uganda , including inadequate funding, shortage of health workers,
• limited availability of essential medicines, and commodities and
challenges in accessing services due to geographical distance and
financial barriers.
• These bottlenecks impact the effective delivery of maternal, newborn
and child health services as well as other essential health
interventions.
Cont
1. Funding and resources:
• Inadequate funding:
Insufficient government funding for the health sectors, including
primary healthcare, limits the ability to expand infrastructures, train
personnel, and procure essential medicines and supplies.
• Resource constraints :
Shortages of essential medicines and commodities, including vaccines
and diagnostic tools can hinder the effective delivery of service.
cont
• High costs:
Patients face significant financial barriers to accessing healthcare,
including high costs and lack of insurance.
• Lack of financial protection:
Many Ugandans lack financial protection against medical costs,
impacting their ability to seek timely care.
Cont
[Link] resources :
• Shortages and distribution :
A lack of qualified healthcare professionals, particularly in rural areas, impact
service availability and quality. Uneven distribution of staff also create disparities
in access.
• Low morale and retention:
Poor working conditions, lack of incentives, and inadequate training
opportunities can lead to high turnover rates and low morale among healthcare
workers.
• Inadequate training:
Many health professionals do not receive sufficient training.
Cont
3. Accessibility and Utilization
• Geographical barriers:
Long distance to health facilities, especially in rural areas, pose significant
challenges for accessing services.
• Financial barriers:
High cost of care, including transportation, consultation fees and
medication, can deter people from seeking treatment.
• Cultural and social barriers:
Cultural beliefs and social norms can also influence health – seeking
behavior, affecting the uptake of certain service.
Cont
• Geographical barriers:
Accessibility to health services, especially in rural areas, is a major
concern.
• Infrastructure gaps:
Inadequate hospitals, health centers, and medical equipment hinder
quality care.
• Poor maintenance:
Government facilities are often poorly maintained and in disrepair.
Cont
4. Supply chain Issues:
• Inefficient supply chains:
Challenges in producing, storing and distributing essential medicines
and supplies can lead to stock outs and delays in service delivery.
• Inadequate infrastructure:
Lack of proper storage facilities and transportation infrastructure can
hinder the effectives management of the supply chain.
Cont
5. Quality of care
• Lack of data and monitoring:
Insufficient data collection and monitoring systems hinder the
identification of bottlenecks and the tracking of progress.
Cont
6. Weak Leadership and Governance:
• Poor Coordination and Communication:
Lack of coordination between different levels of governance, and a lack
of collaboration and capacity building, further impede effective PHC
service delivery.
• Weak Leadership and Political Will:
Weak leadership and governance, along with low political will, can
hinder the effective implementation of PHC programs.
Cont
7. Poor Patient Flow Processes:
Inefficient patient flow processes can lead to long waiting times and
frustration for patients.
• Lack of Community Involvement:
Inadequate community involvement and engagement can hinder the
effectiveness of PHC programs.
• Lack of community participation:
• Involving communities in planning and implementing health programs
is crucial but often lacking.
Cont
• High disease burden:
Uganda faces a high prevalence of infectious diseases, like malaria,
HIV/AIDS, and tuberculosis, which strain the healthcare system.
• Poor health literacy:
Lack of understanding about health issues can hinder preventive care
and adherence to treatment.
• Data limitations:
Data availability and quality are important for monitoring and
improving services, but these are often lacking.
Cont
• Discriminatory perceptions:
Certain groups may face discrimination when accessing healthcare.
• Weak leadership and governance:
Ineffective leadership and governance can hinder the development and
implementation of health policies.
• Social determinants of health:
Poverty, poor sanitation, and a young, rapidly growing population
further exacerbate healthcare challenges.
Addressing these bottlenecks
Requires a multi –pronged approach, including
• Increased funding :
Allocating adequate resources to the health sector, particularly primary
health care.
• Human resource development:
Investing in training, recruiting, and retention of healthcare personnel,
particularly in underserved areas.
• Improving accessibility
Expanding access to health facilities through infrastructure development
and transportation initiatives.
Cont
• Strengthening the supply chain:
Optimizing procurement, storage and distribution of essential
medicines and supplies.
• Enhancing data collection and monitoring:
Strengthening data systems to track progress and identify areas for
improvement.
• Community engagement :
Involving communities in planning and implementing health programs
to ensure that services are culturally appropriate and meet their needs.
