Are global health leaders in Uganda effectively strengthening local public health systems?


Global health leadership in Uganda is linked with the provision of billions of dollars via large-scale global health aid NGOs.  Generally, most of this aid is distributed into vertical programs, focusing on specific diseases.


The Baylor College of Medicine-Bristol-Myers Squibb-Texas Children’s Hospital-Children’s Clinical Centre of Excellence at Mulago Hospital, Kampala, funded by PEPFAR

 As well as their specific goals, most of the NGOs explicitly incorporate health system strengthening into their objectives. But are they doing enough to ensure that the rhetoric becomes reality? It is difficult to be convinced of the contrary, when one observes the disparities between the provision of high-quality care to patients enrolled in NGO-funded programs, to that which members of the same community receive in the public health system.

ImagePublic health system-funded ward at Mulago

A roughly two-fold situation may exist: NGOs may not be effectively strengthening local public health systems as well as they might; in addition there may exist some potentially adverse (while inadvertent) consequences of vertical programs on public health systems.

 Clearly, strategies to ensure Ugandan health system strengthening must be a collaborative effort between donor and recipient. The 2008 NGO Code of Conduct for Health System Strengthening was created to serve as a guide for NGOs working to limit their harmful effects and maximize their contributions to strengthening public health systems. In addition to this, the Ugandan Ministry of Health has launched the Uganda Health System Strengthening Project, a government initiative set out to assist the country achieve the Uganda National Minimum Health Care Package, with a focus on maternal health, newborn care and family planning.

 While applauding the undeniable progress made by vertical programs funded by today’s global health leaders, in the future we must strive to build on these efforts while ensuring true health system strengthening and ‘Health for all’.


Tags: , ,

One Response to “Are global health leaders in Uganda effectively strengthening local public health systems?”

  1. lilamcconnell Says:

    The idea you raise here is an interesting one because it targets the need for enhanced communication and collaborative action among the stakeholders involved in the Ugandan healthcare delivery. Based on your blog post, it sounds as though the field is very siloed. This is interesting because in our public health classes, professors constantly tout the need to blend vertical and horizontal programming so that productive partnerships develop as opposed to individualized groups each trying to effect change in their own way. While this is an excellent idea in theory, I think it is much more difficult to translate into practice.

    I would also be interested in better understanding the effect that the recent anti-gay bill may have on donor funding. The blog on this topic mentions that many global organizations are threatening to cut their funding to Uganda, and by extension some of its health programs, which would undoubtedly have a negative impact on the work of not only the NGOs but also public Ugandan healthcare.

Leave a Reply

Please log in using one of these methods to post your comment: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: