NORTHERN UGANDA: St. Mary’s Hospital Lacor in Gulu is demonstrating against a more than 50% reduction in its primary healthcare budget.
The hospital director, Dr. Martin Ogwang, says that they have been receiving Shillings 600 million for primary health care, which accounts for 5 percent of the annual budget of the hospital, but the Health Ministry reduced it to Shillings 230 million this financial year.
He explains that the Ministry of Health has directed them to benefit from the result-based financing, which is only about a difference between 150 million and 200 million, released on a quarterly basis.
“We have engaged the Ministry of Health and the answer they gave us is that now we have a result-based funding in place and Lacor should earn from that and you must do certain activities and have a certain quality to earn this money,” Ogwang told Uganda Radio Network in an interview.
He explained that the money comes with a budget line and the hospital cannot use it independently to provide services in the key priority areas of primary health care, adding that the hospital requires a billion shillings from the government to close off the funding gaps.
He also noted that despite the huge budget cut to the hospital by the government, the Uganda Revenue Authority (URA) has continued to tax medical supplies. Records from the hospital show that URA taxed the hospital Shillings 248 million in the last 24 months for medical supplies.
Ogwang notes that they only managed to pay 121 million shillings, leaving a balance of 127 million shillings, which they have failed to settle because of resource constraints. “We have petitioned both the Ministry of Finance and the Ministry of Health to waive off some of these taxes.” “I don’t know whether they want us to close operations or increase the medical bills,” he wondered.
Dr. Dominique Atim, the daughter of the late Dr. Corti Lucile, who founded the hospital, has similarly raised concerns about the funding gaps in the hospital. Atim explained that COVID-19 has affected their donor funding as the world battles with the pandemic, in addition to the current Russian-Ukraine conflict, which has affected medical supplies.
She noted that the hospital was established in the 1960s to provide the best health care services to needy patients, but the changing donor pattern now compromises the strategic mission of the hospital to provide care.
The hospital also faces challenges from the high cost of quality verification for the equipment to enter the country and maintenance, which is 20 percent of the cost of their purchases.
The hospital largely depends on donations. In fiscal year 2022/23, the hospital expects to raise 67 percent of its Shillings 25 billion budget through donations.Patients’ bills would account for 27%, with the government expected to contribute 5%, but the hospital received only Shillings 234 million.
Legislators from Acholi have petitioned the government to increase funding for Lacor Hospital from 5 percent to 30 percent. Although the government has acknowledged the funding gap for the hospital, the Permanent Secretary in the Ministry of Health, Dr. Daina Atwine, said that there was no money.
Founded in 1959 as a faith-based, nonprofit private health facility with a 30-bed capacity, the hospital has progressively grown over the past decades and currently has 483 beds. At the peak of the Northern Uganda insurgency led by the Lord Resistance Army, many of the health facilities in the region collapsed, leaving Lacor with the burden of health care provision in the region.