Free Access | June 2017

UNIVERSAL HEALTH COVERAGE IN UGANDA: THE CRITICAL HEALTH INFRASTRUCTURE, HEALTHCARE COVERAGE AND EQUITY

Authors/Editors: Swaibu Mbowa (PhD) ,  Francis Mwesigye (PhD) ,  Tony Odokonyero ,  Annet Adong

Abstract:

Universal Health Coverage (UHC) is a key Sustainable Development Goal (SDG) target, with countries like Rwanda and Ghana pursuing bold policy initiatives such as national health insurance schemes. Beyond financing, critical health infrastructure and Human Resources for Health (HRH) are vital for UHC. Using administrative data from IntraHealth Uganda, document reviews, and Demographic & Health Survey data, this paper analyzed Uganda’s health infrastructure and HRH, evaluated UHC progress, and assessed equity using the Composite Coverage Index (CCI) and Coverage Gap Scores. Results highlight fundamental challenges in Uganda's health infrastructure, including spatial inequality in facility distribution and private sector investment. Low health workforce density severely limits the expansion of healthcare services. While progress in reproductive, maternal, newborn, and child health (RMCH) interventions showed marginal improvement, the CCI remains low, with persistent regional and socioeconomic disparities. Crucially, findings confirm that higher healthcare coverage correlates directly with better health outcomes. To accelerate UHC progress, Uganda must increase infrastructure investments, leverage Public-Private Partnerships in underserved regions, and improve HRH density by updating staffing norms and making deliberate investments (inspired by Rwanda's HRH model). Scaling up RMCH coverage requires sustaining immunization gains while addressing gaps in lagging areas. Achieving these targets ultimately requires coherent policy reforms, particularly in health financing, drawing lessons from successful regional precedents.