Uganda’s mixed health financing system creates challenges for achieving universal health coverage but offers opportunities for improvement through better resource pooling and provider autonomy.
A new research article published in the Health Systems and Reform Journal examines the challenges and opportunities associated with achieving Universal Health Coverage (UHC) in Uganda.
The study explores the complexities of Uganda’s health financing system, characterized by multiple purchasing arrangements. While this presents potential for collaboration, it also leads to conflicting incentives and inefficiencies in resource allocation.
The authors analyze Uganda’s healthcare purchasing functions and their impact on UHC. Their findings highlight:
- A minimum healthcare package targeting key health issues, but with patchy provisions due to insufficient domestic funding and service duplication by development partners.
- Selective contracting with private providers.
- A mix of government budgetary funding and output-based financing from development partners, with the latter linked to service quality.
- The need for clearer UHC targets and improved resource pooling through harmonised government and donor priorities.
- The importance of greater provider autonomy, enhanced work planning, direct facility funding, and flexible resources to deliver high-quality services aligned with local needs and UHC goals.
This research suggests that Uganda’s path to UHC requires a more streamlined and efficient health financing system that leverages the strengths of various purchasing arrangements while addressing fragmentation and misaligned incentives.
