Civil Society Organisations internalize on health tax, National Health Insurance Scheme (NHIS), and partnerships as possible alternative financing models of health in spite of the government’s slow action to prioritize the sector.

As we get close to reading of the annual national budget, CSOs amplify their voices towards increased allocation of funds to the health budget as opposed to budget cuts.  

As of the Financial Year 2015/16, the household out of pocket expenditure on health stood at 42%, way above the World Health Organization (WHO) recommended maximum out of pocket expenditure of 15%. This exceeds the Government expenditure currently standing at only 17%.

While speaking at the virtual Youth Online dialogue on health sector financing organized by Youth Equality Centre (YEC) and Public Health Ambassadors Uganda (PHAU),  Executive Director, Civil Society Budget Advocacy Group Julius Mukunda accentuates that the lockdown has taught us a number of things; we need to double our efforts to advocate for adequate financing for health.

Mukunda’s submission on other alternative financing models for health that we could explore include the national health insurance scheme and health tax.

“The former is a good option where everyone is contributing proportionately to their earnings. Also, the health tax could be deducted from any good, then allocated to a separate account to be tracked and monitored.”

While speaking at the virtual Youth Online dialogue on health sector financing, Diana Tibesigwa. Policy and Campaigns Officer, World Vision Uganda presented findings on a youth study on Sexual Reproductive health financing in Uganda. In FY 2020/21, the health sector budget increased by 5.4% from UGX 2595.38 billion in FY 2019/20 to UGX 2735.96 billion FY 2020/21. However, the share of the health budget to the total national budget decreased from 6.4% in FY 2019/20 to 6.2% in 2020/21.

Budget allocations for reproductive health supplies increased from UGX 11.5 billion in 2017/18 to UGX 14.7 billion in 2019/20 and 14.7 billion maintained for 2020/2021.

However, she notes, there was a decline from UGX 16 billion in 2018/19.  It should be noted that 80 percent of the reproductive health budget line is allocated towards Mama Kits and 20 percent caters for Family Planning (FP) commodities.

Due to inadequate funding, stock-outs of FP commodities have continued to be experienced, especially in public facilities.

“Some funds are spent on other issues such as supervision, monitoring, and mentoring. For the three FYs, there was no budget allocation for capacity building.”

Diana Nambatya, Deputy Country Director, Community Health partnerships emphasized, at such hard times, community engagements are critical in moving health forward because an illness is universal and healthcare is not. Mobilizing money is not enough without increased accountability.

Tibesigwa said, young people need to collaborate and partner with opinion and campaign leaders to further their advocacy efforts. Also, engage decision-makers on key issues of Sexual Reproductive Health Rights.

Context

The year 2020/21 will mark the first fiscal year for implementation of the NDP III and there has been a decline from the 40.5trillion shillings in FY 2019/20 to 39.6 trillion for FY 2020/21. It’s of great importance therefore to note that Objective no. 4 of the NDP places emphasis on the role of the health sector in contributing towards increasing productivity, inclusiveness, and wellbeing of the population for wealth creation.

The sector falls under the Human Capital Development Programme whose goal is to increase the productivity of the population through strategic investment in the people to enable them to work productively and competitively to achieve a rising quality of life for all, in line with the Vision 2040. Unfortunately, the health sector has continued to witness budget cuts over the past years. In FY 2020/21, the proposed health budget is UGX 1,550.4 billion indicating a whole shortfall of UGX 1,039.075 billion from the FY 2019/20 allocation which was UGX 2589.4 billion. Now such a decline is a threat to human capital development

Commitment

A concept note for the dialogue reads, Uganda through President Yoweri Museveni did commit in November 2019 during the ICPD 25 Nairobi Summit to eliminate all obstacles that stand in the way of girls’ empowerment. In addition to that, promote universal access to all methods of family planning, operationalize the National Sexuality Education framework, and focal emphasis on human capital development as of Uganda’s NDP III.