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Article

13 Jan 2025

Author:
Philip Wafula, Daily Monitor - Kampala

Uganda: Private healthcare facilities cited in exploitation of patients through opaque pricing practices, undermining consumer rights and hindering informed decisions

“Govt asked to regulate private health facilities”, Monday, January 13, 2025

Concerns over the lack of effective regulations in Uganda’s healthcare sector have sparked calls for reforms as reports emerge of private facilities exploiting the regulatory gaps to charge exorbitant fees. While the healthcare facilities, including private ones, are regulated by the government through the Directorate of Health Governance and Regulations, its efforts are undermined by challenges such as understaffing, limited resources, ill-defined regulations, and inadequate enforcement mechanisms. Despite steps taken by government to set standards for private healthcare providers, weak enforcement has allowed some facilities to exploit patients through opaque pricing practices, undermining consumer rights and hindering patients from making informed healthcare decisions. As per the 1995 Constitution, the government is obliged to provide quality healthcare to its citizens and ensure health living of its people; where it falls short, it invites the private sector. A health professional, who declined to be named, says “Consultation fees in private hospitals around Kampala range from between Shs 50,000 and Shs 200,000. They can charge higher but there must be a limit or regulation.” For example, if I go to one private hospital for an Intensive Care Unit (ICU), it is about Shs 1.5m per day, and Shs 2m per day in another. Why doesn’t the Ministry of Health regulate and say, ‘the maximum for ICU is, say Shs 1m’?”

Reports of consultants spending more time at private hospitals than public facilities, and some of them owning or being shareholders at the private facilities have continued to plague the Ministry of Public Service. The disparity in service costs is further exacerbated by the dual roles of some health workers, who prioritize their private practices over public service roles, even after receiving salary increments in 2022. This has led to allegations of absenteeism and patients referrals from public hospitals to private facilities owned by the same health workers. In 2022, health workers received 100 percent salary increase, which saw senior medical consultants’ salaries increase from 7.3m to 17.4m, medical consultants’ pay were increased to Shs 12.7m, principal medical officers from Shs 4.5m to Shs 8m, enrolled nurses, from 613,000 to Shs 1.3m. In 2022/2023 financial year, the government allocated Shs 3.722 trillion to the health sector, including a wage bill increase to address staffing gaps. However, the service delivery remains hampered by absenteeism, which currently stands at nearly 20 percent. For a country like Uganda, costs need to be regulated so that people can easily access these services as it is worse when there are outbreaks like the 2020 Covid-19 global pandemic, where some facilities hiked their prices almost by 100 percent, which denied a section of the population the much-needed services. A public dialogue at the Makerere University School of Public Health in August 2021 noted that as the second wave of the Covid-19 pandemic ravaged several countries in developing world, including Uganda, the capacities of public health facilities were exposed especially in managing increased cases of Covid-19…