Health Systems Reforms in Uganda: Processes and Outputs

Abstract

During the 1970s and 1980s, Uganda went through a period of political and economic upheaval, resulting in the breakdown of many services. In the health sector this was characterized by general system failure. Funding was grossly insufficient, leading to problems of meagre and late salaries for health workers, permanent shortages of medicines and supplies, and dilapidated infrastructure. The National Resistance Movement, headed by President Yoweri Museveni, took power in 1986. Initial efforts by this government were focused on the restoration of law and order and on the reestablishment of public systems. However, there was minimal government funding available for social services including the health sector. Many bilateral and multilateral donors intervened to provide post-conflict support including emergency rehabilitation of the health infrastructure. These international agencies focused their support on specific aspects of the health sector (usually disease programmes) in particular parts of the country. Districts which were closer to the capital city and easily accessible attracted many donor projects, while districts which were remote and difficult to access received few or no projects at all.