May
1st is International Labour Day, a day which commemorates a time of civil
unrest in the late 19th century when workers in industrialized countries
demonstrated for improved working conditions, wage raises and the establishment
of a maximum working day and week. Many of the demonstrations were suppressed
with force.
The
conditions for workers in Uganda are not something to talk about since the NRM caught
power in 1986. The problem has all along
been president Museveni’s wrong vision for the country. This ill advised vision has seen brains
migrate to greener pastures as Museveni decided to invest in wars to remove
leaders of neighbouring countries among other region conflicts. People have been well trained, but
unfortunately, the looters of the national treasury have taken the cake that
would reward the hard work of the skilled worker and what we continue to see is
migration of labour many of whom are beneficiary of state sponsorship. The matter has not been made better by salary
scales which are upside down! While some
executives earn about shs 25 million a month, many senior people are paid
peanuts, which is very demoralizing.
The
decentralization has not helped matters.
Corrupt politicians are party to policies and decisions that demoralize
the technical manpower. Everything is a
mess in Uganda!
What
my save the Uganda worker as of now is the peaceful exist of President
Museveni, short of that, sorry!
Museveni’s
way of doing things unfortunately is self defeating. He is now the chief pay officer, who decided
to make a double pay to Members of parliament when they have already been paid
for the work, while other salaried Government officers have no salary and
motivation at all.
President
Museveni is a road block to any meaningful reforms in Government, hence the
reason we see that one proposal for increased revenue is increased tax
rates! While, adjustments in Government
and stopping the thieving can do a lot for the ruined economy.
As
Uganda Workers Mourn may 1st, the only prayer remains for the NRm
organ to see sense and devise means of seeing Museveni retire, short of that,
no hope for the Ugandan worker!
William
Kituuka Kiwanuka
Challenges of
retaining health workers in the PNFP Sector:
The Case of Uganda
Catholic
Health Network
Sam
Orochi Orach - Asst. Executive Secretary, Uganda Catholic Medical Bureau
Abstract
Shortage
of human resource for health poses a major challenge to achieving the Millennium
Development Goals (MDGs). Uganda is among the 57 countries with human resource
shortage reaching critical level. But the situation is even worse at micro
levels. The private-no-for-profit (PNFP) health sub-sector complements
government efforts to achieve the MDG, the health sector strategic plan II
(HSSP II) and the health related poverty eradication plan (PEAP) indicators.
Uganda
Catholic Medical Bureau coordinates the Roman Catholic health facilities
network, one of the three PNFP networks in Uganda. This paper looks at the HRH
crisis as experienced by the UCMB network giving the trend, examining the reasons,
the destinations of attrition cases and what the network is trying to do to
improve human resource stability. The information is based on quarterly reports
received by the bureau from its affiliated health facilities.
Introduction
Uganda
is among the 57 countries with critical shortage of health workforce (The World
Health Report 2006). The high burden of disease, including HIV/AIDS, requires
scale up of some of the most labor-demanding interventions. The lean health
workforce experiences heavy pressure to implement increasing range of services
within the national minimum health care package (UMHCP) and meet the targets
for the Health Sector Strategic Plan II, the Poverty Eradication Plan (PEAP)
and the Millennium Development Goals (MDGs). There is also pressure to see further
downward trend in the HIV prevalence. It has been estimated that the scale up
of antiretroviral therapy (ART) alone in Uganda between 2005 and 2012 would
demand a doubling or tripling in staff time given to ART (Rudolf Chandler and
Stephen Musau, 2004). To scale up anti-retroviral therapy alone to meet the
PEPFAR target would require about 10% of Uganda’s doctor workforce as at 2004
level (Smith O. 2004).
But
scale-up of ART in Uganda has even moved faster than originally planned while
health workforce remained almost unchanged.
This disproportionate growth in service demand and the skewing of health
workforce deployment in favour of few diseases conditions worsen the functional
gap in respect to implementing the range of services in UMHCP. But this is
worsened by a workforce that is increasingly becoming unstable.
Retention
of Health Workers Health worker instability is worsened by, among others, internal
and external movements or losses. HIV is reported to be the leading cause of
health worker attrition in developing countries (WHO 2007; EQUINET AND HST
2004). Death, for example, in 10 years accounted for 30% of the 1984 cohort of
Ugandan medical school graduates, 50% of which was due to HIV (Yoswa M
Dambisya, 2004). But at a cross-sectional level the main reason for internal
and external movements of Ugandan health workers is “poor working condition”
(Charles W. Matsiko and Julie Kiwanuka, 2003), which often simply means
poor pay. There is also desire to move out of rural to urban areas. These
affect both the public and the not-for-profit (PNFP) sectors.
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