Your guide to health insurance in Uganda
Thinking of moving to Uganda? You'll no doubt have many questions on the healthcare system here. Located in the African Great Lakes region and within the Nile basin, Uganda has a varied climate. This "pearl of Africa" is home to rich natural diversity and a burgeoning art scene. You will find much of the cultural action happening in the hilly urban capital of Kampala.
In this Pacific Prime article, we'll give you a snapshot of the Ugandan healthcare system, as well as your health insurance options here.
Overview of the healthcare system
One of the biggest obstacles facing Uganda is the lack of proper funding. In 2002, Uganda spent 7.4 percent of its Gross Domestic Product (GDP) on the public healthcare sector. However, how much of this funding actually makes it into the health sector is uncertain. In addition, the World Bank has estimated that $300 million USD of foreign aid and state funding was lost to corruption in 2008.
Most of Uganda's many health clinics and schools are concentrated in urban areas. There is no funding to pay for teachers, medicine, supplies, physicians, nurses, and other administrative staff. So, a majority of hospitals and clinics are over-crowded with patients trying to get basic medical care and supplies. In a country where malaria is one of the leading causes of death, anti-malarial medicine can scarcely be found. On the other hand, senior administrative members of the Ministry of Health can be found with 4 X 4 vehicles and other luxuries, while some hospitals struggle with only a handful of ambulances.
To exacerbate the situation, while healthcare is supposed to be free, many medical personnel are known to demand under-the-table payments. The government has made pledges to curb corruption and to improve the organization and distribution of foreign aid and government funds. However, this remains to be seen.
Uganda's public healthcare system
Here, most medical institutions are religiously based, and run by three main nonprofit providers: Uganda Catholic Medical Bureau, Uganda Protestant Medical Bureau, and the Uganda Medical Bureau. Nongovernmental organizations are also heavily involved in HIV/AIDS counseling and treatment. Centered on a referral basis, Uganda’s healthcare system is organized into 5 major tiers.
1. Village health teams/community medicine distributors
Your first points of contact are the village health teams (VHT) and medicine distributors. Volunteers run these health teams, but the majority of the time, they are non-existent or cannot provide treatment since they lack basic supplies and drugs. Usually, the VHT only offers advice and necessary referrals to higher up clinics.
2. Health center II
The second level consists of out-patient facilities called Health Center IIs. In Uganda, at least one of these clinics is stationed in every sub-district, and supposedly led/run/operated by a nurse, a midwife, and other health workers. Serving a few thousand patients, health center IIs should be able to treat common diseases like malaria and offer prenatal care.
3. Health center III
You will see larger facilities called health center IIIs at the third level in every sub-county. Generally speaking, there are roughly 18 staff at these health centers. There should be a laboratory for diagnosis purposes, an outpatient clinic, and a maternity ward. Some sub-counties may not have health center IIIs. Instead, they'll have an even higher-level facility.
4. Health center IV
Health center IVs are small hospitals at the fourth level. These provide the same services offered in health center IIIs, but they are able to serve many more patients and wards.
Finally, hospitals sit at the highest level. They should provide all services offered in the other levels in addition to being home to larger facilities and specialists. Each district should have one hospital. Unfortunately, the number of physicians, nurses, and other administrative staff at these hospitals highly varies. Within the tier, there are also sub-divisions. District referral hospitals are not as well equipped as the national referral hospital, which is where the best medical facilities and services are found. However, even here, the standards are well below western ones.
Private not-for-profit health clinics
Most public healthcare institutions are located in urban areas. As a result, medical costs may exceed what the majority of Ugandans can afford. Private not-for-profit (PNFP) health clinics exist as a third option to public and private practices. However, these clinics usually only offer basic medical services and are likely to be temporary.
PNFP health centers charge a medical fee, so the poorest populations still cannot access health services here. Taking on a loan to pay for much needed medical services often leaves those who cannot afford treatment in an even greater state of poverty.
Quality of Ugandan healthcare
Here, health workers have a tendency to extort money from patients desperate for services. In fact, doctors are paid very low salaries and work on the side at private clinics. Also common is the lack of essential drugs at public medical facilities. The private health sector helps supplement the lackluster government system.
Overall, the quality of care and infrastructure, and the quantity of medicine and supplies are well below Western standards. The overwhelming majority of Ugandans do not have access to healthcare. Travelers and expatriates traveling to Uganda will be able to use these facilities. However, be forewarned that beyond basic medical services, most hospitals cannot provide much more. In the event of a serious illness or injury, travelers will have to be evacuated to a different country. These expenses are known to be as much as $100,000 USD! Thus, it is imperative to purchase a policy that will cover medical evacuation and transportation costs.
Uganda health insurance
Community Health Insurance (CHI) schemes are owned and managed by the hospitals that were established during the late 90’s. Few people are covered by the Community Health Insurance (CHI) as hospitals cannot afford the costs, especially after the Department for International Development (DFID) withdrew much of its financial support in 2002.
Travelers should get vaccinated against yellow fever, hepatitis A, hepatitis B, typhoid, rabies, tetanus-diphtheria, mumps, measles, rubella, and meningococcus. In addition, malaria is prevalent, so visitors need to carry anti-malarial medicine, sleep in bed nets, and use insect repellent. UK health authorities have classified Uganda as having a risk of Zika virus transmission. Always bring adequate supplies of personal prescription medicine and a doctor’s note for these prescriptions. It is also recommended that travelers bring diarrhea medicine, as diarrhea is a common ailment of travelers in this part of the world. Petty and violent crime also occur in Uganda, and terrorist attacks are likely to be carried out here. Therefore, it's important to remain vigilant particularly in crowded areas and public places.
Protect yourself with private health insurance
Traveling to Uganda carries multiple health risks. Here, the quality of the healthcare facilities are also a far cry from hospitals back at home. That's why you should protect yourself with international healthcare insurance.
We would also recommend an insurance plan that covers your repatriation costs. If you are injured, you may want to receive the best care for your condition outside of the country. In most cases, the cost to transfer you back home can be incredibly steep!
Pacific Prime has over two decades of experience as brokers in the insurance industry. We are committed to finding the perfect health insurance plan to suit your budget and needs. Most importantly, our highly-trained experts provide free quotations, leverage our close partnerships with all major insurers, and have an extensive portfolio that consists of all the best plans. Contact us today so we can help!