Health Check: Ugandans' experiences and opinions on health services

Three out of ten Ugandans have experienced an accident or injury in the past six months, either personally (4%) or through a friend (12%) or household member (16%). Among these, half (53%) were related to boda-bodas and 25% are related to the road more generally.

These findings were released by Twaweza in a research brief titled Health Check: Ugandans’ experiences and opinions on health services. The brief is based on data from Sauti za Wananchi, Africa’s first nationally representative high-frequency mobile phone survey. The findings are based on data collected from 1,913 respondents across Uganda in October 2018. 

Broadly, citizens have mixed views about their health services but they see more challenges in accessing health care compared to 2017. 

There has been an increase in the proportion of citizens facing specific challenges in health centres. More citizens complain about long waiting times (from 72% in 2017 to 81% in 2018), a lack of medicines or other supplies (70% to 78%), lack of attention or respect from staff (43% to 55%) and absent doctors (37% to 44%).

Citizens report that their average journey time to their nearest health centre is over an hour (74 minutes). There are significant differences between rural (84 minutes) and urban (47 minutes) areas, and between poorer (91 minutes) and wealthier (53 minutes) households.

Despite the increase in complaints about long waiting times, 4 out of 10 users of health facilities are attended to within 30 minutes. However 2 out of 10 (20%) are still forced to wait more than two hours. The starkest difference, however, is between government and private / NGO facilities; in government facilities 24% are seen within 30 minutes while in private or NGO facilities, 67% are.

Government facilities are also more likely to provide patients with prescriptions but not the medicine itself. Although similar numbers of citizens are given prescriptions and medicine in government and private or NGO facilities, in private facilities they are much less likely (10%) to be just given a prescription and left to buy the medicine themselves compared to in government facilities (33%).

Half of citizens (56%) also say they or someone they know has been admitted to hospital in the past year. Among these, 62% were admitted to government facilities. Among all patients, almost all of them slept in a bed while they were in hospital. However 4% slept on a mattress on the floor and 3% slept on the floor directly. This is consistent across different facilities. However, in government hospitals, 7% of patients shared their bed while in private facilities, 2% did.

The provision of universal health care is emphasized in Uganda’s health policies. Vulnerable groups such as pregnant women, children under 5 and adults over 60 are entitled to free treatment at government facilities. However, among all these groups, 1 out of 5 of citizens say they have seen a member of these groups having to pay for public health services.  

In terms of suppliers for health services, most Ugandans rely on the government: 50% of Ugandans sought help from a government facility the last time they or someone they know was ill or injured, 29% made use of private or NGO facilities while 9% went directly to the pharmacy for medication. In addition, 2% of Ugandans have health insurance.

Read more: health services



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