Cost Pricing of Drugs and Structural framework for health care delivery in uganda.
Health services in Uganda are delivered through public sector and private providers specifically the private not for profit (PNFP) and private health practitioners (PHP). Public health services are by policy provided free of charge but fall short of meeting the health needs of the entire population. The public sector is insufficiently staffed, experiences frequent medicines stock outs, and has a poorly motivated staff (MoH and Macro, 2008; MoH, et al., 2012). On the other hand, private health providers are considered to have relatively better quality services and, for this reason, the private sector has been shown to be the preferred provider for both rich and poor Ugandans (Pariyo et al.,2009).
Private health providers have the ability to locate services to areas with high demand, though most of these again are in urban locations. However, the mechanism of payment for services by the private providers specifically “fee for service” is a critical barrier to access and utilization of health services by the population especially for the poor and underprivileged communities. The capacity of the private providers is further undermined by weak organisational, coordination and governance systems.
They are mainly sole proprietorships, easily set up and dissolved-a situation that compromises service sustainability. The focus on profitability, though good for resource mobilisation and sustainability of provided services, can result into less compliance to health policy guidelines and/or professionalism in service delivery, particularly with insufficient regulatory oversight. The private health sector has not been an ideal approach to achieving equity in health. PHPs are demand driven and are thus, mainly concentrated in the urban areas that have populations that have higher ability to pay for services.
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