SP4PHC in Uganda
The Government of Uganda has initiated key steps towards achieving universal health coverage. These include developing the 2016 Health Financing Strategy and planning for a national health insurance scheme. The current purchasing landscape is fragmented due to the myriad of purchasing schemes, from supply-side government budgetary allocations to donor-funded results-based financing programs. ThinkWell and learning partner Makerere University School of Public Health collaborate with the Ministry of Health and other stakeholders to support strategic purchasing reforms, drawing from the experience of results-based financing and voucher programs and leveraging public and private health providers. For more information, view our Uganda overview presentation and one pager. To see how our SP4PHC team in Uganda has helped its government respond to Covid-19, view our Covid-19 response page.
SP4PHC has two key strategies to strengthen primary health care access and quality in Uganda.
Strategy 1: Harmonize and strengthen purchasing arrangements
SP4PHC is supporting the MoH to harmonize and strengthen purchasing arrangement as per the 2016 Health Financing Strategy. This is done in part through evaluation of existing purchasing schemes (including both results-based financing and voucher programs) to build consensus around approaches to make purchasing more strategic. Through facilitating dialogue and collaboration, SP4PHC is bringing the priorities of maternal, newborn, and child health and family planning to the forefront and is generating support for harmonization of these disparate purchasing schemes to move towards universal health coverage.
Strategy 2: Support the development of an approach for GOU through the Kampala Capital City Authority to effectively purchase FP and MNCH services from private providers
In many urban settings, public sector infrastructure is limited and there is an abundance of largely disconnected private providers. Public facilities offering services are overburdened and service delivery is highly congested. The Kampala Capital City Authority (KCCA) aims to bring together and leverage these private providers to make PHC and RBF purchasing more strategic. The SP4PHC team is facilitating dialogue between the MoH, KCCA and other key stakeholders to formalize existing initiatives through a public-private hybrid network in order to more efficiently purchase PHC services, with a focus on MCH and FP.
These three factsheets below serve as a reference and aim to visualize the latest data and trends on purchasing family planning, maternal & newborn health services, and a broader overview of purchasing in Uganda. Each factsheet also highlights some of the activities the SP4PHC country team is working on with local stakeholders within that topic area. These factsheets are updated annually (latest in May 2021).
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National Health Insurance in sub-Saharan Africa: Insights for Uganda
Following advances of the 2019 National Health Insurance Scheme (NHIS) Bill through Parliament in early 2021, Uganda is now pushing forward on the design of the scheme to support progress towards Universal Health Coverage. This study draws on the experiences of six sub-Saharan African (SSA) countries that have achieved the highest levels of population coverage—namely Rwanda, Ghana, Gabon, Tanzania, Ethiopia, and Kenya—to highlight insights and lessons learned for Uganda in the core areas of enrollment, benefits package design, financing, and implementation sequencing for the NHIS.
An Overview of Health Financing Flows in Uganda
This report documents the nature and magnitude of financial flows to Uganda’s health sector and the purchase of primary health care services. Against international benchmark estimates that $86 per person is required to deliver essential health services in low- and middle-income countries, this study documents that the current level of government funding to primary health care services are below levels needed if Uganda is to achieve its universal health coverage goals.
Reproductive Health Voucher Schemes in Uganda: How They Worked and Lessons for the Future
Uganda has more than a decade of experience working with voucher schemes to improve reproductive and child health services. With the Government of Uganda actively engaged in moving forward with strategic purchasing reforms, ThinkWell and the Ugandan Ministry of Health partnered to document the experiences and lessons learned from the most recent large-scale voucher projects that include the Second Uganda Reproductive Health Voucher Project and the Uganda Voucher Plus Activity. The team’s poster from the 6th Global Symposium on Health Systems Research can be viewed here. The findings of this effort are summarized in this report published in February 2021. To read a blog our team recently published in P4H that summarizes the key findings and implications from this voucher analysis, please click here.
How Primary Health Care Services are Financed in Uganda: A Review of the Purchasing Landscape
An in-depth landscape of Uganda’s health purchasing policies and practices. This report answers the key questions: Who purchasers health services, and from whom? What mechanisms are used to purchase services? and What services are purchased? Insights from this landscape, published in September 2020, inform the project’s ongoing work to support strategic purchasing reforms in the country.
Uganda’s Emergency Response to the COVID-19 Pandemic: A Case Study
A review of Uganda’s initial institutional, financial, and operational responses to the COVID-19 pandemic. The case study, published in September 2020, provides insights to the priorities and investments made early in the outbreak that inform the current response and potential long-term reforms that can improve the health system.
SP4PHC aims to improve how governments purchase primary health care services, with a focus on family planning and maternal, newborn, and child health. SP4PHC is supported by a grant from the Bill & Melinda Gates Foundation.