Uganda Accelerates Healthcare Reforms to Achieve Universal Health Coverage by 2030

Speaking at the 5th Annual Ministerial Meeting of the Group of Friends of UHC and Global Health on Tuesday in New York Dr. Aceng detailed the country’s comprehensive reforms aimed at bolstering financial protection for Ugandans and addressing disparities in healthcare access.

“We found that underfunding, stock-outs in public health facilities, reliance on private healthcare, and inequitable access were driving the high out-of-pocket expenditures,” she revealed in her speech. “To address these challenges, Uganda has embarked on several key reforms, such as increasing domestic resources.”

Dr. Aceng highlighted the significant progress Uganda has made toward achieving UHC, noting that the country’s service coverage index had doubled from 22% in 2000 to 50% by 2020. “Despite this impressive progress, challenges persist, particularly regarding financial protection for the vulnerable,” she stated.

One of the most alarming challenges is the level of catastrophic health expenditures. “In 2020, 13.6% of Ugandans faced catastrophic health expenditures, a stark reminder that achieving true UHC requires much more than improving access to services,” she explained.

In response, Uganda has implemented reforms aimed at increasing domestic resources for healthcare. “Over the last three years, we have more than doubled our domestic health budget. This has been complemented by efficiency reforms to ensure we are using every resource effectively. For example, by integrating health programs and improving our tracking of spending, we are freeing up resources to reinvest in priority areas,” she said.

Dr. Aceng also underscored the importance of equity and quality in healthcare delivery. The Ministry of Health has revised its resource allocation formula to prioritize underserved communities and institutionalized results-based financing in primary healthcare. These efforts, she noted, have already begun to bear fruit, as out-of-pocket health spending has dropped from 44% in 2017/18 to 28% in 2020/21.

Looking to the future, the Health Minister emphasized the need for continued investment in Uganda’s health sector. “We are advocating for health spending increases to align with the Abuja Declaration. We are aiming for 15% of government expenditure and 4% of GDP to be allocated to health.”

To ensure sustainable financing, Uganda is also exploring innovative solutions, including sin taxes and debt-to-health swaps. These mechanisms are designed to secure long-term funding for healthcare services, thus reinforcing the country’s commitment to achieving UHC.

“Financial protection is at the heart of our mission. We remain steadfast in our efforts to ensure that health systems work for all, especially the most vulnerable,”