Health workers in Kampala Capital City Authority (KCCA) health facilities have welcomed a six-week health monitoring exercise by the State House health monitoring unit, saying it could help identify and address challenges affecting service delivery, including funding, staffing, and infrastructure gaps.
Miriam Aliisa, the in-charge of Kisugu Health Centre III, said the exercise could help bring challenges identified at health facilities to the attention of higher levels of government for action. She also called on the government to engage directly with health workers to better understand the challenges they face in delivering services.
Aliisa raised concerns about overcrowding, inadequate staffing and limited infrastructure, saying the challenges affect the quality of care and make it difficult for health workers to give patients adequate attention. She cited maternal health services as an example, saying some expectant mothers are reluctant to transfer from Kisugu Health Centre to Naguru, where they are referred for services that Kisugu cannot provide.
Aliisa said the mothers prefer Kisugu because it is closer to their homes and they are familiar with the facility. She added that Naguru Health Centre is often overcrowded, with inadequate sanitation and fewer health workers compared to the number of patients seeking care.
“It is very much packed, the hygiene is not up to date, the toilets are full, so the nurses are few, and the patients are many, so there is no attention,” Aliisa said. She, however, explained that referrals are necessary because Kisugu operates at Health Centre III level and does not have an operating theatre.
The facility attends to about 160 to 180 mothers each month. Aliisa said that in emergency cases, health workers assess mothers and provide treatment where possible before referring those who require specialised or higher-level care.
She also called for health workers to be treated professionally whenever disciplinary action is necessary, arguing that frontline workers should be engaged by people who understand the realities of healthcare delivery. Her comments come amid concerns about health workers being held responsible for shortages of essential medicines.
“We heard of a certain nurse who was put in jail because the drug was out of stock. Is it her challenge? Is it her to bring the drugs?” Aliisa asked. She said medicine shortages and other resource constraints require systemic solutions rather than placing responsibility solely on individual health workers.
“We need people who can understand what we do, who can understand our language and to handle us like human beings,” she said. At Kisenyi Health Centre IV, Moses Thembo, the manager of medical stores, said the facility faces challenges involving health workers allegedly telling patients that medicines and other consumables are unavailable and advising them to buy the items from private drug shops.
Thembo also raised concerns about delays in recruiting health workers for KCCA facilities. He said he has worked for KCCA for 10 years, during which several employees have died or left their jobs, but have not been replaced.
Speaking during a meeting with health workers, KCCA officials and the Kampala minister at the launch of the exercise on Tuesday, Dr Waren Namara, who heads the State House health unit, said the assessment would cover hospitals and health centres under KCCA.
The team will investigate what he described as “organised absenteeism” involving doctors, nurses, midwives and other health workers. “We want to look at whether that is being done. Why should the government pay the money that it pays? And then you absent yourself?” Namara said.
The team will also assess whether medicines supplied to health facilities are properly stored and made available to patients, as well as the state of health infrastructure and staffing levels. Namara said patient experiences would also form part of the exercise, including allegations of rude treatment, unofficial charges and extortion at health facilities.
Namara stressed that the exercise was not intended to target individual health workers, but rather to identify weaknesses and improve service delivery. “It’s not fault-finding; it is for purposes of improving the services,” he said. The exercise will also examine how public funds allocated to health facilities are utilised.
Namara, however, cautioned against interpreting the investigation as an accusation that funds had been stolen. “I have not talked about money being stolen, but we shall look at utilisation of funds. Are they applied inappropriately or appropriately?” he said.
He added that the team would go beyond information presented on the surface when assessing the facilities. “We dig deeper. We are not just surface investigators. Any attempts to falsify information would be difficult to conceal during the exercise,” Namara said.
Hajjat Minsa Kabanda, the Minister for Kampala and Metropolitan Affairs, said the State House monitoring team had approached her seeking to understand the situation in Kampala health facilities. Kabanda said several concerns about health facilities had been raised on different platforms, including social media, but that she could not investigate all of them alone. She welcomed the exercise, saying the monitoring team was expected to produce an independent report that could help improve health service delivery in Kampala-URN. Give us feedback on this story through our email: kamwokyatimes@gmail.com
