HEALTH SERVICE MANAGEMENT

DCM 3

SESSION TWO
 HEALTH SERVICE MANAGEMENT
IN UGANDA

Learning Objectives
1. Explain the meaning of Health Service management
2. Describe Public health system
3. Describe the organisation of health services in
Uganda
4. Describe Private-not for profit (PNFP)
5. Describe the Private for profit (PFP)
 HEALTH SERVICE MANAGEMENT
IN UGANDA
• Health Service Management is the process of planning,
directing, coordinating and supervising the delivery of
health care to a given community or population
• Health service delivery in Uganda is one of the
constitutional obligations of the government to its people
• The government therefore budgets and funds all health
promotion, preventive and curative as well as
rehabilitative health services for her people
• This is the so-called Public Health System
 Organisation of Health Services in
Uganda

• In Uganda, the health services is organized under

the following three main levels
1. National level,
2. Regional level and
3. At district level
 National level organisation of health
services
• The national health system is made up of Public
and Private sectors
• The Public health system includes all facilities of the
MoH, MoD, MoE and Ministry of Internal Affairs
• The Private health system is made up of Private not
for profits(PNFP), Private for profits (PFPs) and
Traditional and complementary Medicine
Practitioners(TCMP)
• The private health system provides about 50% of
standard units of output
 National level organisation of health
services
• In Uganda the health services are decentralized
following the political system
• At the national level, the system has the MoH and
the National Referral Hospitals (Mulago and
Butabika)
 The core functions of the Ministry of
Health
 Policy analysis, formulation and dialogue
 Strategic planning
 Setting standards and quality assurance
 Resource mobilization
 Advising other Ministries, departments and agencies on
health related matters
 Capacity development and technical support
supervision
 Provision of nationally coordinated services including
health emergency preparedness and response
 The core functions of the MoH cont.
Epidemic prevention and control
Coordination of health research and
Monitoring and evaluation of the overall health
sector performance
 National referral hospitals
• They provide comprehensive specialist services
• They are involved in health research and teaching
• Besides those services, they also provide general
services being provided by general hospitals (i.e.
curative, prevention, promotion and rehabilitative
services)
• So far, there are only two national referral hospitals
in Uganda (Mulago and Butabika) however the 3rd
one being prepared is Mbarara hospital but
conversion not yet complete
 Regional Referral Hospitals
• These are hospital serving regions and they are 12
in numbers in Uganda
• They offer specialist clinical services such as
psychiatry, ENT, Opthalmology, higher level surgery
and medical services and clinical support services
(laboratory, medical imaging and pathology)
• They are also involved in teaching and research in
addition to services provided by general hospitals
• Regional referral hospitals report to the center (MoH)
 Leadership & Management of health
services in Uganda
• Due to de-centralization, the functions of leadership
and management of health services in Uganda is at
the district level
• The District Health Team (DHT) chaired by the
District Health Officer (DHO) provides leadership for
health care services at the district level
• The DHO coordinates all the health programs within
the district and ensures that there is effective health
service delivery in the district
 Leadership & Management of health
services cont.
• For effective service delivery and easy management,
the district is again sub divided into health sub-districts
• At the health sub-district, a Medical Officer (MO)
assists the DHO in managing the health care services
• Together with other lower health facilities in-charges,
the MO carry out the functions of planning, directing,
coordinating and supervising the health care delivery
at the lower health facilities
 Private –not for profit
• These are Health services borne out of religious and
missionary foundations (Faith Based Services)
• They are organized into bureaus (e.g. Uganda
Catholic, Protestant and Muslim medical bureaus)
• They are founded to provide free health services to
their flock and they tend to specialize in the
provision of curative health service to the community
• With the mushrooming of NGOs in the country, there
are now more PNFPs in the country